肝后下腔静脉的应用解剖  

Applied anatomy of retrohepatic inferior vena cava

作　　者：徐旭东 王杰 徐林钢 丰振 张苍旭 杨子帆 张也 李捷 任美峰 XU Xu-dong;WANG Jie;XU Lin-gang;FENG Zhen;ZHANG Cang-xu;YANG Zi-fan;ZHANG Ye;LI Jie;REN Mei-feng(Basic Medicine School of Jining Medical College,Jining,Shandong Province 2720671 China)

机构地区：[1]济宁医学院基础医学院人体解剖学教研室,山东济宁272067

出　　处：《解剖学研究》2021年第4期321-325,共5页Anatomy Research

基　　金：济宁医学院2019年大学生创新训练计划项目(cx2019106)。

摘　　要：目的通过对肝后下腔静脉、第二肝门、第三肝门的详细观测,为肝脏外科手术的临床实践提供解剖学参考。方法随机选择40具成人尸体离体肝脏标本,从正后方剖开肝后下腔静脉,测量第二肝门处肝静脉的口径、长度、与下腔静脉的角度;观测第三肝门处肝短静脉的数量及分布。结果肝左、中、右静脉的内径分别为(9.17±3.58)mm、(9.50±3.53)mm、(13.72±3.28)mm;长度分别为(11.66±7.63)mm、(12.90±8.22)mm、(9.18±7.63)mm;与下腔静脉的角度分别为(59.75±15.02)°、(72.73±37.36)°、(46.58±24.72)°。肝门间段的距离为(8.67±5.09)mm,此间段内部分标本可观察到孔径<1 mm的肝短静脉小开口。SHVs开口主要分布于下腔静脉左前壁(Ⅱ、Ⅵ、Ⅹ区)和右前壁(Ⅲ、Ⅶ、Ⅺ区);SHVs孔径≥1 mm的主要分布于左前壁(Ⅱ、Ⅵ区)、右前壁(Ⅶ、Ⅺ区)及右后壁Ⅻ区。IRHV主要分布于Ⅺ区、Ⅻ区,数量1~3支,内径为(5.48±2.53)mm。结论肝后下腔静脉的精细解剖,可为肝脏手术入路的选择、肝外伤、肝切除、肝移植以及布加综合征的介入治疗提供重要的解剖学参考。Objective To measure the statistics of inferior vena cava(IVC)behind the liver,the second hepatic portal and the third hepatic portal,provide anatomy reference for the clinical practice of liver surgery.Methods Choose 40 isolated liver specimens randomly which are from adult corpses.Inferior vena cava was then incised along its posterior wall in order to expose the openings of the hepatic veins.Measure the diameters,length of the second hepatic portal and the angle between the IVC.Measure the number of short hepatic vein(SHVs)and the distribution in the third hepatic portal.Results The inner diameter of the left,middle and right hepatic respectively were(9.17±3.58)mm,(9.50±3.53)mm and(13.72±3.28)mm,respectively;The length of them were(11.66±7.63)mm,(12.90±8.22)mm and(9.18±7.63)mm,respectively;The angle between IVC respectively were(59.75°±15.02°),(72.73°±37.36),and(46.58°±24.72°),respective-ly.The distance between two hepatic portals was(8.67±5.09)mm,and small openings of short hepatic veins<1mm were observed in some specimens of this segment.SHVs openings mainly locate in the left front wall(Ⅱ,Ⅵ,Ⅹ)and the right front wall(Ⅲ,Ⅶ,Ⅺ)of the IVC.The inner diameter of SHVs≥1mm were locate in the left front wall(Ⅱ,Ⅵ),the right front wall(Ⅶ,Ⅺ)and the right back wall of the IVC.IRHV mainly locate in the zone of Ⅺ,Ⅻ.The number of the vein was 1 to 3,the diameter of them was(5.48±2.53)mm.Conclusion The fine anatomy of the posterior inferior vena cava can provide important anatomic reference for the choice of liver surgical approach,liver trauma,liver resection,liver transplantation and the interventional treatment of Budd-Chiari syndrome.

关 键 词：肝后下腔静脉 肝静脉 肝短静脉 第二肝门 第三肝门 应用解剖 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学]