發(fā)布時(shí)間：2018-06-22 21:09

  本文選題：肝 + 肝靜脈　； 參考：《青島大學(xué)》2007年碩士論文

【摘要】： 目的:通過(guò)解剖測(cè)量的方法對(duì)第二、三肝門(mén)內(nèi)的主肝靜脈和肝短靜脈的位置、分型、數(shù)量、管徑等參數(shù)進(jìn)行觀察和測(cè)量,以期為臨床上中心型肝癌的切除、尾狀葉腫瘤的切除、肝臟移植病肝的切除、活體肝移植供肝的獲取等提供解剖學(xué)基礎(chǔ)。 方法:應(yīng)用60具成人尸體標(biāo)本,觀察以下參數(shù):1.下腔靜脈(IVC)肝后段的口徑變化以及與肝靜脈開(kāi)口的關(guān)系;2.肝左、中、右靜脈的肝外長(zhǎng)度、注入IVC管徑、與鐮狀韌帶的夾角;3.第三肝門(mén)中肝短靜脈(SHVs)分別匯入下腔靜脈的左側(cè)壁、前壁和右側(cè)壁,SHVs分為左、中、右三排,觀察并測(cè)量SHVs的數(shù)量、位置、口徑及其與主肝靜脈的關(guān)系;4.沿IVC后壁正中線切開(kāi)肝后段,測(cè)量肝右后下靜脈(IRHV)的口徑、位置和肝外行程。 結(jié)果:解剖學(xué)觀測(cè)結(jié)果顯示:1.IVC肝后段近心端內(nèi)徑為(28.8±1.12)mm,遠(yuǎn)心端內(nèi)徑為(22.2±1.05)mm,肝左、中、右靜脈開(kāi)口于IVC肝后段上1/4段,其中肝左、中靜脈共干者73%(44例),肝左、中、右靜脈共開(kāi)口者2%(1例),三支分別匯入者25%(15例),肝左靜脈開(kāi)口位置最高,其次為肝中靜脈,肝右靜脈開(kāi)口位置最低;2.肝左靜脈注入IVC管徑值為7.1-18.1(10.3±1.9)mm,肝外長(zhǎng)度為2.2-17.9(6.7±1.3)mm,與鐮狀韌帶間的夾角為32.29±11.23°;肝中靜脈注入IVC管徑6.9-18.9(11.8±2.3)mm,肝外長(zhǎng)度為2.4-10.8(5.4±1.3)mm,與鐮狀韌帶之間的夾角為43.04±11.55°;肝右靜脈注入IVC管徑值為9.5-22.1(13.7±2.6)mm,肝外長(zhǎng)度為2.6-11.8(6.8±1.5);3.SHVs 3～35支從不同的方向和節(jié)段注入IVC,其直徑為1.5-17.8(5.4±1.4)mm。肝右靜脈直徑與SHVs直徑呈負(fù)相關(guān),肝左靜脈直徑與SHVs數(shù)目呈正相關(guān)。IRHV出現(xiàn)率為83.3%,平均直徑為2.6-8.0(4.3±1.2)mm,位于肝臟面腎壓跡處,開(kāi)口位置低,有1～2mm的肝外行程,IRHV直徑大小與肝右靜脈大小呈負(fù)相關(guān)。 結(jié)論:IVC自下而上先向右前上方,后向左后上方至隔的IVC裂孔,在腔靜脈溝中呈凸向右的弓形彎曲;該彎曲處為IVC相對(duì)狹窄的區(qū)域;肝左、中靜脈共同匯入IVC者居多73%,肝左、中、右靜脈中,肝右靜脈管徑最粗,而肝左靜脈的肝外長(zhǎng)度最長(zhǎng)。不同肝臟標(biāo)本SHVs的變化大,多數(shù)情況下,管徑粗者數(shù)量少,管徑細(xì)者數(shù)量多。SHVs的口徑、數(shù)目和主肝靜脈口徑、數(shù)目相互補(bǔ)償。肝右靜脈直徑愈大SHVs直徑愈小,肝右靜脈直徑愈小SHVs直徑愈大。肝左靜脈直徑愈大SHY數(shù)量越多少,肝左靜脈直徑愈小SHVs數(shù)量愈少。
[Abstract]:Objective: to observe and measure the location, classification, quantity and diameter of the main hepatic vein and the short hepatic vein in the second and third hilar of the liver by anatomical measurement. The anatomical basis is provided for liver resection of liver transplantation disease and the acquisition of donor liver from living donor liver transplantation. Methods: 60 adult cadavers were used to observe the following parameters: 1. 1. The diameter of the posterior segment of the inferior vena cava (IVC) and its relationship with the opening of the hepatic vein. The extrahepatic length of the left, middle and right hepatic veins was injected with the diameter of IVC and the angle between the right vein and the falciform ligament. The short hepatic vein (SHVs) of the third middle hepatic porta was introduced into the left wall of the inferior vena cava, the anterior wall and the right wall of SHVs were divided into three rows: left, middle and right. The number, position, caliber and relationship between SHVs and the main hepatic vein were observed and measured. The posterior hepatic segment was cut along the median line of the posterior wall of IVC, and the diameter, position and extrahepatic travel of the right posterior inferior hepatic vein (IRHV) were measured. Results: the anatomical results showed that the proximal diameter of the posterior segment of the IVC liver was (28.8 鹵1.12) mm, the diameter of the distal end was (22.2 鹵1.05) mm, the left, middle and right veins of the liver were open to the upper 1 / 4 segment of the posterior segment of the liver of IVC, the left and middle hepatic veins were 73% (44 cases). The total opening of right vein was 2% (1 case), and that of three branches was 25% (15 cases) respectively. The position of the left hepatic vein was the highest, followed by the middle hepatic vein and the lowest position of the right hepatic vein. The diameter of IVC was 7.1-18.1 (10.3 鹵1.9) mm, the extrahepatic length was 2.2-17.9 (6.7 鹵1.3) mm, the angle between IVC and falciform ligament was 32.29 鹵11.23 擄, the diameter of IVC was 6.9-18.9 (11.8 鹵2.3) mm, the external length was 2.4-10.8 (5.4 鹵1.3) mm, the angle between IVC and sickle ligament was 43.04 鹵11.55 擄, the diameter of IVC was 9.5-22.1 (13.7 鹵2.6) mm. The external length of IVC was 2.6-11.8 (6.8 鹵1.5) / 3.The diameter of IVC was 1.5-17.8 (5.4 鹵1.4) mm. The diameter of right hepatic vein was negatively correlated with the diameter of SHVs, and the diameter of left hepatic vein was positively correlated with the number of SHVs. The occurrence rate of IRHV was 83.3, with an average diameter of 2.6-8.0 (4.3 鹵1.2) mm. There was a negative correlation between the diameter of 1~2mm and the size of right hepatic vein. ConclusionTwo one IVC from bottom to top, from left to the septal hole of IVC, is arched to the right in the sulcus of vena cava, which is a relatively narrow area of IVC, and the left and middle veins of liver are mostly confluence of IVC, left and middle of the liver. In the right vein, the diameter of the right hepatic vein was the thickest, and the extrahepatic length of the left hepatic vein was the longest. The changes of SHVs in different liver samples were great. In most cases, the number of diameter of SHVs was small, and the number of diameter of SHVs was more. The diameter of SHVs and the diameter of main hepatic vein compensated each other. The larger the diameter of the right hepatic vein, the smaller the diameter of S HVs and the smaller the diameter of the right hepatic vein. The larger the diameter of the left hepatic vein, the more S HY, the smaller the diameter of the left hepatic vein, the less the S HVs.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R657.3;R322

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