肝尾状叶的突起及其毗邻关系的解剖研究

目的 为肝尾状叶手术提供形态学依据。方法 选用福尔马林固定的离体无病变成人肝脏34例，对肝尾状叶的突起及其毗邻结构进行观察。结果 本组34例肝尾状叶均有尾状突，该突位置较恒定，前邻肝门静脉，右邻下腔静脉，左邻乳头突，后邻右膈脚。11例(32．3％)肝尾状叶有较明显的乳头突，该突前邻肝门静脉左支，右邻尾状突，左邻静脉韧带裂，后邻腹主动脉。尾状突和乳头突下方有肝总动脉横过。32例(94．1％)肝尾状叶有下腔静脉后突，该突前下邻下腔静脉及第三肝门，前上邻下腔静脉及第二肝门，后邻膈。下腔静脉后突包绕下腔静脉后壁的1／3至2／3，平均包绕下腔静脉后壁1／2；其中2例(5．9％)完全包绕下腔静脉与肝右叶相遇。结论 肝尾状叶的突起与三个肝门紧邻，对其精确定位是手术顺利实施的关键之一。

RESEARCH ON THE ANATOMY OF THE HEPATIC CAUDATE LOBE PROCESS CORRESPONDING RELATIONS

Objective To provide anatomic foundation for the operation of the hepatic caudate lobe process. Methods To choose 34 cases livers of adult that without pathological process fixed by formalin to observe the hepatic caudate lobe process and its corresponding relations and analyze them by statistics. Results 34 subjects showed caudate process averagely and their position are stable with forth to hepatic portal vein, right to inferior vena cava, left to papillary process, and bake to right crura of diaphragm. 11 cases (32.3%)of them have obvious papillary process, their forth to hepatic portal vein, right to caudate process, left to fissure of venous ligament and back to abdominal aorta. The common hepatic artery cross under the caudate process and papillary process. 32cases (94.1%) of them have inferior vena cava process. their below part are next to inferior vena cava and the third hepatic portal, while their above part are next to inferior vena cava and the second hepatic portal. The process rounds the back wall of the inferior vena cava about the position of their 1/3 to 2/3part, averagely 1/2. Among of them, 2 cases (5.9%) of them rounds completely, and links to right lobe of liver. Conclusion The caudate process is connected with three hepatic portals. The definition of their pqrition accurately are one of important factor to do operations.