本文關鍵詞： 活體肝移植 肝臟 解剖 門靜脈 肝動脈 膽管 肝靜脈 下腔靜脈　出處：《第一軍醫(yī)大學》2005年博士論文　論文類型：學位論文

【摘要】：肝移植是治療終末期肝病公認有效的方法,成人右葉部分肝移植是擴大成人供肝來源的良好途徑,因為肝臟解剖結構的復雜性,右葉部分肝移植的應用,尤其是右葉部分活體肝移植在臨床上應用受到一定的限制。右葉部分肝移植涉及供肝臟質量的評估、體積或質量的計算,肝動脈、膽管、門靜脈、肝靜脈和肝短靜脈或其分支的解剖、分離、切取與重建,其中任何一個環(huán)節(jié)成功與否都關系到受者是否能有高質量的生存,對于活體肝供者不僅經歷一次較大的身體上創(chuàng)傷,也是經歷履行家庭社會責任,承受巨大心理壓力、實現(xiàn)個人價值的一次嚴峻考驗。中國為肝病的高發(fā)病區(qū),有許多終末期的肝病患者需要肝移植治療,而供體極為匱乏。本研究從解剖學角度觀察肝臟各管道的結構、分布規(guī)律,結合右葉肝移植具體術式進行解剖研究,為中國臨床上廣泛開展右葉部分肝移植,尤其是活體右葉肝移植提供相關的解剖學基礎。 材料和方法 一.41例新鮮肝臟標本,43例非肝病死亡者成人福爾馬林固定尸體肝臟標本,91個肝臟鑄型標本:觀察、統(tǒng)計肝內及肝周的管道的走行、分支、匯合類型、變異情況。 二.41例新鮮肝臟標本,43例非肝病死亡者成人福爾馬林固定尸體肝臟標本,觀測指標:(1)肝靜脈的分支數(shù)、最大徑、長度、肝外長度、走行、匯合、注入IVC管徑、注入IVC部位、與IVC角、與鐮狀韌帶夾角、與膈的距離;右后下肝靜脈、右后中肝靜脈的數(shù)目、大小:右上緣支、左上緣支的數(shù)量;肝后IVC、肝
[Abstract]:Liver transplantation is recognized as an effective method for the treatment of end-stage liver disease. The adult right lobe partial liver transplantation is a good way to expand the source of adult donor liver, because of the complexity of the anatomical structure of the liver and the application of the right lobe partial liver transplantation. In particular, right lobe partial liver transplantation is limited in clinical application. Right lobe partial liver transplantation involves assessment of donor liver quality, calculation of volume or mass, hepatic artery, bile duct, portal vein, portal vein, hepatic artery, bile duct, portal vein, hepatic artery, bile duct, portal vein, hepatic artery, bile duct and portal vein. The dissection, separation, extraction and reconstruction of hepatic veins and short hepatic veins or their branches are related to the survival of the recipients, and not only to the living liver donors, but also to a larger physical trauma. It is also a severe test of fulfilling family and social responsibilities, enduring tremendous psychological pressure, and realizing personal value. In China, where liver disease is a high incidence area, many end-stage liver disease patients need liver transplantation treatment. In this study, the structure and distribution of hepatic ducts were observed from the anatomical point of view, and the anatomical study was carried out in combination with the specific operation methods of right lobe liver transplantation, so that the right lobe partial liver transplantation could be widely carried out in China. In particular, right lobe liver transplantation in vivo provides anatomic basis. Materials and methods. 41 fresh liver specimens of 43 adult cadaveric liver specimens fixed with formalin and 91 liver cast specimens: observation and statistics of the passage, branch, confluence type and variation of intrahepatic and perihepatic ducts. 2.41 fresh liver specimens and 43 adult cadaveric liver specimens from non-liver dead persons. The number of branches, maximum diameter, length, extrahepatic length, walk, confluence, IVC diameter, and IVC site of hepatic vein were observed by observing the number of branches, maximum diameter, length, extrahepatic length of hepatic vein. Angle with IVC, angle with falciform ligament, distance from diaphragm; number and size of right inferior hepatic vein, right posterior middle hepatic vein: right superior marginal branch, number of left superior marginal branch; posthepatic IVC, liver
【學位授予單位】：第一軍醫(yī)大學
【學位級別】：博士
【學位授予年份】：2005
【分類號】：R322;R657.3

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本文編號：1552668