带血管蒂肾上腺转位治疗柯兴氏病  

The vascular basis of pedicled adrenal transposition and its usage in the treatment of Cushing′s disease

作　　者：赵守元 刘德海 阎利沙 赵留方 苗延宗[1,2] 宋良[1,2] 

机构地区：[1]郑州解放军第一五三中心医院泌尿外科 [2]河南医科大学附属第一医院泌尿外科

出　　处：《中华外科杂志》1997年第10期626-629,共4页Chinese Journal of Surgery

摘　　要：为研究膈下和肾上腺上动静脉的长度及外径、肾上腺静脉回流方式以用于治疗柯兴氏病，作者在手术中解剖出上述血管用游标卡尺进行长度及外径测量。用带血管蒂肾上腺背部肌间转位治疗柯兴氏病６例。结果显示，右膈下动脉从下腔静脉右缘至末支肾上腺上动脉长７５～１１０ｍｍ，左膈下动脉从腹主动脉左缘至末支肾上腺上动脉长７０～９０ｍｍ，均有伴行静脉。肾上腺上动脉源于膈下动脉，末支外径１．５～２．５ｍｍ，分离后长４０～８０ｍｍ。肾上腺转位时的血管蒂由肾上腺上动静脉或膈下肾上腺上血管组成。治疗病例随访４～３５个月，无皮质功能不足或复发。作者认为膈下、肾上腺上血管分离后长度能够使保留的肾上腺达到转位床。带血管蒂肾上腺肌间转位是治疗柯兴氏病较理想的术式。To treat Cushing′s disease,we studied the length and exterior diameter of the inferior phrenic and superior adrenal artery and vein,and the reflow of the adrenal vein. The length and exterior diameter of those blood vessels were divided and measured by veiner calipor.Six patients with Cushing′s disease were treated by pedicled adrenal transposition to the musculus of the back.The right inferior phrenic artery was 75￣110mm from the exterior edge of the vena cava to the distant branch of the superior adrenal artery, while the left inferior phrenic artery was 70￣90mm from the left edge of the aorta to the distant branch of the superior adrenal artery, both of which have veins to accompany them.The superior adrenal artery came from the inferior phrenic artery relatively common and was divided into six branches. The exterior diameter of the distal superior adrenal artery was 1 5￣2 5mm and could be freed for 40￣80mm . Lateral veins could complete the adrenal blood drainage after the left central adrenal vein was ligated. The transpositioned blood vessel pedicle consisted of the distant inferior phrenic artery and vein, the distant branches of the superior adrenal artery and vein. The patient who had received the transposition treatment had neither hypocortisolism nor recurrence after 4 to 35 months .The length of the inferior phrenic,superior adrenal gland vessels could content the remained adrenal gland to reach their transposition bed when freed. The pedicled adrenal transposition to the musculi is an ideal method in the treatment of Cushing's disease.

关 键 词：肾上腺 血管 库兴综合征 转位 

分 类 号：R586.205[医药卫生—内分泌]