活体肝移植肝右静脉的临床解剖研究  

Clinical anatomy of the right hepatic vein for living donor liver transplantation

作　　者：刘本菊[1] 周庭永[1] 钱学华[1] 张琳[1] 王剑华[1] 李彦彦[1] 吕发金[2] 

机构地区：[1]重庆医科大学解剖学教研室 [2]重庆医科大学第一附属医院放射科,重庆400016

出　　处：《中国临床解剖学杂志》2009年第3期270-274,共5页Chinese Journal of Clinical Anatomy

摘　　要：目的:为活体肝移植(LDLT)提供有关肝右静脉(RHV)的形态学资料。方法:利用50例无病变成人尸体肝脏进行剥离解剖,对RHV和副肝静脉进行观察,测量RHV主干及相关数据并进行统计分析。结果:RHV 80.0%(40/50)开口于下腔静脉(IVC)肝后段上份10:00处,其肝外段长(5.8±3.5)mm,外科干长(7.0±5.5)mm,主干长(68.3±30.2)mm,汇入IVC处内径为(10.7±2.4)mm;主干在距IVC 1 cm、2 cm、3 cm、4 cm及主干汇合起始处上壁距肝膈面的距离分别为(10.8±5.3)mm、(22.7±7.0)mm、(32.8±8.2)mm、(40.1±7.3)mm、(33.5±9.8)mm;RHV与IVC的夹角为(40.5±9.4)°;根据RHV的引流范围及有无直径≥5.0 mm的副肝右静脉将RHV分为两型,各型再分为两个亚型。直径≥3.0 mm和≥5.0 mm的副肝右静脉出现率分别为60.0%(30/50)、32.0%(16/50)。结论:RHV解剖变异较大,其引流范围受副肝右静脉和肝中静脉的影响,LDLT术前应掌握其结构特点,制定合理的手术方案。Objective： To provide morphological data concemed with the right hepatic vein （RHV） for living donor liver transplantation （LDLT）. Methods： 50 non-illness adult cadaveric livers were dissected, RHV and accessory hepatic vein were observed, and main trunk of RHV and correlated data were measured and analyzed statistically. Results： For 80.0%（40/50 ）specimens, the opening site of RHV to inferior vena cava（IVC） were at 10： 00 of its upper part. The extrahepatic length of RHV was about （ 5.8±3.5 ）ram, the length of surgical trunk and main trtmk were （7.0±5.5）mm and（68.3±30.2）mm respectively. The internal diameter of main trunk at the site of joining to IVC were （10.7±2.4）mm.The distances to facies diaphragmatica hepatis from the joining site to IVC about lem, 2cm, 3cm and 4cm, and from the confluency beginning site of the superior wall of main trunk were （ 10.8±5.3 ）mm, （22.7±7.0）mm, （32.8±8.2）mm, （40.1±7.3 ）mm and （33.5±9.8 ）mm, respectively. The angle between RHV and IVC was about（40.5±9.4）°. According to the draining scope of RHV and the occurrence of accessory right hepatic veins with the diameter ≥ 5.0 ram, RHV was divided into two types, including 2 subtypes for each type. The frequency of accessory right hepatic veins with the diameter exceeding 3.0mm and 5.0mm were 60.0% （30/50） and 32.0% （16/50）, respectively. Conclusions： RHV is variable. Its draining scope is influenced by accessory right hepatic vein and middle hepatic vein, therefore its anatomic features should be understood for rational operation plan.

关 键 词：肝右静脉 活体肝移植 解剖 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学]