十二指肠降部的解剖学特点及临床意义  

Anatomic features and clinical significance of the descending duodenum

作　　者：田东[1] 钟利[2] 吴溢[2] 王佳玮[2] 王喻[2] 胡丹丹[3] 赵国刚[4] 付茂勇[1] 

机构地区：[1]川北医学院附属医院胸心外科,四川南充637000 [2]川北医学院临床医学系,四川南充637000 [3]川北医学院医学影像系,四川南充637000 [4]川北医学院附属医院普外科,四川南充637000

出　　处：《中国临床解剖学杂志》2011年第3期284-286,290,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的为内镜诊治十二指肠降部疾病及减少医源性损伤提供应用解剖学。方法 40例福尔马林固定成人尸体标本,解剖观测十二指肠降部的外形、长度,大乳头的形状、位置以及上曲、下曲、大乳头处的内周径、外周径、肠壁厚度。结果十二指肠降部的外形有竖直形、弧形和不规则形,多为上细下粗,且大部分标本有狭窄,狭窄处肠腔内黏膜为纵形皱襞、稀疏低矮环形皱襞或平坦无皱襞。十二指肠降部长度为(8.2±1.9)cm;上曲、下曲、大乳头处的肠腔内周径分别为(4.8±1.7)cm、(5.8±1.3)cm、(6.9±2.3)cm;肠管外周径分别为(7.0±1.3)cm、(8.8±1.2)cm、(9.2±1.6)cm;内侧肠壁厚度分别为(2.29±0.63)mm、(1.91±0.49)mm、(1.75±0.73)mm;外侧肠壁厚度分别为(1.63±0.53)mm、(1.42±0.37)mm、(1.54±0.40)mm。十二指肠大乳头的形状多变,与上曲的距离为(4.3±1.9)cm。结论行内镜检查和治疗十二指肠降部疾病时,掌握和认真观察其解剖学特点,对寻找病变部位及减少医源性损伤有重要意义。Objective To provide applied anatomic data for the diagnosis and treatment of the descending duodenal diseases and reducing iatrogenic endoscopic injury.Methods Forty adult cadaveric specimens fixed with formalin were dissected.The shape and the length of descending duodenum,the shape and location of major duodenal papilla,and the inner diameter,outside diameter,wall thickness at the superior,inferior flexure duodenum and major duodenal papilla were observed respectively.Results The descendent duodenum shaped as vertical,curved or irregular.Most specimens showed the thin upper and thick lower parts,and the narrow part.The mucosa of longitudinal,sparse circular and flat folds could be observed separately.The average length of the descending duodenum was about（8.2±1.9） cm,and the inner diameter at the superior,inferior flexure duodenum and major duodenal papilla（4.8±1.7）cm,（5.8±1.3）cm,and（6.9±2.3）cm,respectively.The average outside diameter was（7.0±1.3）cm,（8.8±1.2）cm,（9.2±1.6）cm,respectively,and inner wall thickness（2.29±0.63）mm,（1.91±0.49）mm,and（1.75±0.73）mm,the outer wall thickness（1.63±0.53）mm,（1.42±0.37）mm,and（1.54±0.40）mm.The major duodenal papilla showed the irregular shape.The distance between the major duodenal papilla and the superior flexure duodenum was about（4.3±1.9） cm.Conclusions It is necessary to understand the anatomic features of descending duodenum for treating the diseases of this area.

关 键 词：十二指肠降部 应用解剖 内窥镜 损伤 

分 类 号：R322.45[医药卫生—人体解剖和组织胚胎学]