奇静脉逆行灌注在主动脉手术中对脊髓保护的解剖学研究  

Anatomical study on azygos vein retrograde perfusion for spinal cord protection during aortic operation

作　　者：张平[1] 王乃利[1] 寇印华[1] 张晓东[1] 

机构地区：[1]中国医学科学院基础医学研究所中国协和医科大学基础医学院解剖学教研室,北京100005

出　　处：《中国临床解剖学杂志》2003年第1期49-52,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的 :为主动脉手术中脊髓保护提供形态基础和术式设计。方法 :解剖观察了 3 1例成人标本的奇静脉系、椎静脉丛 ,以及脊髓静脉回流途径。结果 :观测奇静脉系及相关静脉 ,其直径为 ( x±s) :奇静脉为 (9.2± 1.9)mm ,半奇静脉为 (5 .5± 1.2 )mm ,副半奇静脉为 (3 .8± 0 .9)mm ,左最上肋间静脉为 (2 .0±0 .4)mm ,右最上肋间静脉为 (1.9± 0 .4)mm ,左腰升静脉为 (2 .3± 0 .5 )mm ,右腰升静脉为 (2 .2± 0 .6)mm。根据奇静脉属支的配布和肋间静脉汇入形式 ,将奇静脉系分为 4种类型。奇静脉及其属支中存在静脉瓣 ,有个体差异。脊髓静脉密集 ,与椎内静脉丛有丰富的网络连接 ,并通过神经根静脉与椎外静脉丛、奇静脉系相交通。结论 :在主动脉手术中应用奇静脉逆行灌注脊髓保护 ,是一种行之有效的新术式。Objective: To Provide morphologic basis and operation designs for spinal cord protection during aortic operation. Methods: The human azygos venous system, vertebral venous plexus, and the venous drainage of spinal cord in 31 human adult cadaveric specimens were investigated by means of routine dissection. Results: The azygos venous system and related veins were observed.The diameters were as follows: azygos vein 9.2±1.9 mm, hemiazygos vein 5.5±1.2 mm, accessory hemiazygos vein 3.8±0.9 mm, left superior intercostals vein 2.0±0.4 mm, right superior intercostals vein 1.9±0.4 mm, left ascending lumbar vein 2.3±0.5 mm, right ascending lumbar vein 2.2±0.6 mm.According to the distribution patterns of the tributaries of azygos vein and the forms of intercostals venous opening, the azygos venous system might be divided into 4 types.The venous valves with variable forms and dimensions were found in the tributaries of the azygos vein.The distribution ensity of spinal veins were rich, the vascular anastomoses between spinal veins and internal vertebral venous plexus were abundant.By way of spinal radicular veins, they communicated with external vertebral venous plexus and azygos venous system. Conclusion: It is a new and feasible method to retrograde perfusion of the azygos vein for spinal cord protection during aortic operation.

关 键 词：解剖学研究 主动脉手术 脊髓保护 逆行灌注 奇静脉 

分 类 号：R322.1[医药卫生—人体解剖和组织胚胎学]