右上肺B_(2)下移变异:一种特殊类型的气管支气管  

Variation of right B^(2)downwards-shift:A special type of tracheal bronchus

作　　者：刘治利 张敏[2] 刘兴元 葛明建[2] LIU Zhili;ZHANG Min;LIU Xingyuan;GE Mingjian(Department of Thoracic Surgery,Chongqing University Jiangjin Hospital,Chongqing,402260,P.R.China;Department of Thoracic Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,P.R.China)

机构地区：[1]重庆大学附属江津医院胸外科,重庆402260 [2]重庆医科大学附属第一医院胸外科,重庆400016

出　　处：《中国胸心血管外科临床杂志》2024年第12期1759-1766,共8页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的分析右上肺B^(2)下移支气管血管的变化规律。方法筛选重庆医科大学附属第一医院2019年1月—2022年1月行三维计算机断层扫描支气管血管重建右上肺B^(2)下移变异5280例患者。根据B1+3开口位置将支气管变异分为普通下移型、过下移型和气管支气管下移型。结果最终纳入6例患者,其中男1例、女5例,年龄29~71岁。根据我们的支气管变异分型,本组患者中普通下移型4例(66.7%)、过下移型1例(16.7%)、气管支气管下移型1例(16.7%)。动脉中,上干(Tr.sup)+后支(A.post)型4例(66.7%)、Tr.sup+下干(Tr.inf)+A.post型2例(33.3%)。静脉中,Ⅰab+中间支气管后的右上叶静脉(UVPBI)型2例(33.3%)、Ⅰb+UVPBI型1例(16.7%)、前静脉+UVPBI型1例(16.7%)、中心静脉+UVPBI型1例(16.7%)、中心静脉型1例(16.7%)。结论右上肺B^(2)下移,存在后支和后方斜裂发育差(RS2与RS6互相连接),导致在术中解剖离断B^(2)的难度降低,但需警惕打开后方斜裂时引起的血管损伤。Objective To analyze and summarize the changes of the bronchus and vessels of right B^(2)downwards-shift.Methods The 5280 patients who underwent three-dimensional computed tomography bronchography and angiography between January 2019 and January 2022 were screened.Based on the opening position of B1+3,we classified bronchial variations into a normal type,over type,and tracheal-bronchus type.Results Finally 6 patients were included with 1 male and 5 females,aged 29 to 71 years.According to our bronchial classification,there were 4(66.7%)patients of the normal type in this group,1(16.7%)of over type,and 1(16.7%)of tracheal-bronchus type.About arteries,4(66.7%)patients was the trunk superior(Tr.sup)+posterior artery(A.post)type and 2(33.3%)Tr.sup+trunk inferior(Tr.inf)+A.post type.About veins,2(33.3%)patients were theⅠab+right upper lobe vein posterior to the bronchus intermedius(UVPBI)type,1(16.7%)Ⅰb+UVPBI type,1(16.7%)anterior+UVPBI type,1(16.7%)central+UVPBI type and 1(16.7%)central type.Conclusion In the right B^(2)downwards-shift,A.post exists,and the posterior oblique fissure is poorly developed(RS2 and RS6 are interconnected).Therefore,it is easier for us to dissect and disconnect B^(2)intraoperatively,but it is necessary to be vigilant for vascular damage caused by opening the posterior oblique fissure.

关 键 词：变异 肺 支气管 血管 

分 类 号：R562[医药卫生—呼吸系统]