肝周下腔静脉数字模型的建立  

Establishment of a digital model of juxtahepatic vena cava

作　　者：王铁功[1] 刘汝海[1] 李凤山[1] 张执全[1] 杨冬山[1] 张磊[1] 陈新[1] 

机构地区：[1]河北省沧州市中心医院肝胆科,061001

出　　处：《中华消化外科杂志》2014年第3期202-206,共5页Chinese Journal of Digestive Surgery

摘　　要：目的探讨根据cT检查数据建立肝周下腔静脉数字模型的可行性。方法选取2013年1—5月沧州市中心医院120例受试者（无肝脏基础疾病者）的临床资料。分析受试者CT检查图像，设定肝周下腔静脉4个层次（P1：下腔静脉入右心房水平、P2：肝静脉根部汇入下腔静脉上缘水平、P4：下腔静脉肝脏下缘水平、P=5：肾静脉根部汇入下腔静脉上缘水平）测量周长及各层次间的垂直距离。在假设肝周下腔静脉完全充盈前提下，利用周长计算出肝周下腔静脉各层次的理论直径（P1D、P2D、P3D、P4D），结合不同层次间垂直距离（P1P2L、P2P4L、P1P4L、P4P5L）推导关系式，制作肝周下腔静脉数字模型。对测量数据使用方差分析配对样本t检验及独立样本t检验，使用相关及回归方法分析数据间关系。结果3例受试者同时缺失P1与P2层次数据，8例受试者缺失P4层次数据。各层次理论直径：P1D为（28．1±4．0）mm，P2D为（28．7±3．5）mln，P4D为（23．5±2．7）mm，P5D中位值为24．3mm，P1．P2-P4层次问下腔静脉为-个中间略微突出的柱形立体结构。P1D．P2D，P2D—P4D，P1D—P4D之间直径差距比较，差异有统计学意义（F=77．5，P〈0．05）。进-步分析发现P2D—P4D和P1D—P4D直径差距比较，差异有统计学意义（t=14．893，11．210，P〈0．05）。各层次垂直距离：P1P2L中位值为7．5mm，P1P4L为（85．2±11．0）mill，P2P4L为（78．2±9．8）mln，P4P5L中位值为10．Omm。P1D—P2D、P2D-P4D、P2D—P5D、P4D—P5D之间数据变化呈正相关（r=O．862，0．308，0．186，O．788，P〈0．05），P1D—P4D和P2D—P5D则无相关性（r=0．180，0．118，P〉0．05）。P2D与体质量有关，P5D与年龄有关（r=0．200，0．130，P〈0．05）。男性受试者和女性受试者的下腔静脉P1D、P2D、P4D和P5D分别为（28．5±3．7）mm和（27．8±4．2）mm、（29．0±3．4）mm和（28．5±3．6�Objective To investigate the feasibility of establishing a digital model of juxtahepatic vena eava. Methods The clinical data of 120 participants （without liver diseases） who were admitted to the Cangzhou Central Hospital from January 2013 to May 20t3 were collected. The results of computed tomography were ana- lyzed. The diameters of juxtahepatie vena cava on different levels （P1 plane： inferior vena cava at the entrance to the fight atrium, P2 plane ： the upper margin of the roots of hepatic veins, P4 plane ： lower boundary of liver, P5 plane： confluence of renal veins and inferior vena cava）, and the circumference of the inferior vena cava and the lengths between these levels were recorded. A digital model of juxtahepatic vena eava was established by these data on the premise that the juxtahepatie vena cava was engorged. All data were analyzed using the analysis of vari- ance, paired sample t test and independent samples t test, and correlation and regression were used in analysis of relations between there data. Results Data of the P1 plane and P2 plane were both missed in 3 cases, and thedata of the P4 plane was missed in 8 cases. The theoretical diameter of hepatic vena cava at the P1, P2 and P4 planes were （28.1 ± 4.0） mm, （28.7 ± 3.5 ） mm and （23.5 ± 2.7 ） ram, respectively. The median diameter of hepatic vena cava at the P5 plane was 24.3 ram. The juxtahepatic vena cava was a 3 dimensional structure of cylinder with a slightly protruding middle part. There were significant differences in P1D-P2D, P2D-P4D, P1D- P4D （F=77. 5, P 〈0. 05）. There were significant differences between P2D-P4D and P1D-P4D （t = 14. 893, 11. 210, P 〈 0.05 ）. The median length of hepatic vena cava between P1 and P2 planes was 7.5 ram. The lengths of hepatic vena cava between P1 and P4 planes, P2 and P4 planes were （85.2 ± 11.0） mm and （78.2 ± 9.8） mm, respectively. The median length of hepatic vena cava between the P4 and P5 planes was 10.0 mm. P1D-P2D, P2D-P4D, P2D-PSD and P4D-PS

关 键 词：肝周下腔静脉 数字模型 

分 类 号：R657.3[医药卫生—外科学]