肝尾状叶边界和管道系统实用解剖研究及其临床应用  

Applied anatomical study and clinical application of the caudate lobe boundary and ductal system of the liver

作　　者：黄义华[1] 江新华 袁航 邹华英[1] 毛卫 Huang Yihua;Jiang Xinhua;Yuan Hang;Zou Huaying;Mao Wei(Department of General Surgery,the Ninth Hospital of Nanchang,Nanchang 330002,China)

机构地区：[1]南昌市第九医院普外科,南昌330002

出　　处：《中华肝脏病杂志》2022年第10期1100-1106,共7页Chinese Journal of Hepatology

摘　　要：目的探究肝尾状叶边界及其管道走行关系,以指导肝脏手术时解剖关系的辨别。方法根据41具尸体肝脏解剖标本,观察其特定部位,剔除肝实质,再观察其网状管道结构,探究肝尾状叶与其他肝叶临界关系及其各种管道解剖情况。结果肝门板和Arantius韧带构成的平面可以作为尾状叶与其他肝叶的分界,尾状叶的门静脉由其左右支发出的许多细小分支组成,其中腔静脉旁部的门静脉主要来自左分支,较少来自右分支;尾状叶静脉血经肝短静脉直接汇入下腔静脉;尾状叶胆管可有3~4支;而动脉血供主要来自肝动脉左右分支。尾状叶和肝后下腔静脉之间存在一个由疏松结缔组织构成的无血管区。结论肝尾状叶为一个独立的肝叶。肝门板和Arantius韧带构成的平面可以作为尾状叶与其他肝叶的分界,可在肝尾状叶手术时用于解剖位置辨别。尾状叶的管道系统错综复杂,但也有其自身独特的规律性。Objective To explore the relationship between the hepatic caudate lobe boundary and the ductal system so as to guide the identification of the anatomical relationship during liver surgery.Methods The specific parts were observed and the liver parenchyma was removed according to 41 cadaveric liver autopsy specimens.The critical relationship between the hepatic caudate lobe and other ducts was observed to explore the reticular duct structure.Results The plane formed by the hepatic hilar plate and Arantius ligament served as the boundary between the caudate lobe and other hepatic lobes.The caudate lobe hepatic portal vein was composed of numerous small branches from its left and right branches.The portal vein adjacent to the vena cava was mainly derived from the left branch,and to a lesser extent from the right branch.Blood was drained straight from the caudate lobe vein into the inferior vena cava via the short hepatic vein.There were three or four bile duct branches in the caudate lobe.The main source of arterial blood flow were the left and right branches of the hepatic artery.An avascular zone of loose connective tissue was found between the caudate lobe and the retrohepatic inferior vena cava.Conclusion The hepatic caudate lobe is an independent lobe.During hepatic caudate lobe surgery,the plane formed by the hepatic hilar plate and Arantius ligament can serve as the boundary between the caudate lobe and other hepatic lobes and be used for anatomical site identification.The duct system of the caudate lobe's is complicated,but it also has its own distinct regularity.

关 键 词：尾状叶 下腔静脉 肝短静脉 肝右后下静脉 Arantius韧带 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学]