下腔静脉与肝静脉的外科应用解剖

在３２例成人尸体上进行腔静脉与肝静脉的应用解剖学的研究，观测了右肾上腺静脉、左膈下静脉、主肝静脉的长度、横径、注入角度和部位及主肝静脉的汇合类型和下腔静脉各段长度。结果表明，术中阻断肝上膈下下腔静脉，有８４．４％的人可经腹部切口完成，另１５．６％者可能需开胸在心包内阻断下腔静脉，下腔静脉下阻断，有８７．５％可在网膜孔后分离阻断，１２．５％需行下腔静脉肝后段分离阻断。在游离肝右叶时，需注意可能出现的

Applied anatomy of the inferior vena cava and hepatic vein

The applied anatomy of the hepatic vascular exclusion was performed in 32 adult cadavers.The lengths,calibers,angles of the right suparenal veins,the left inferior phrenic veins and the hepatic veins,as wellas the types of convergence of hepatic veins and the lengths of every segment of the inferior vena cava(IVC)were observed and masaured.The results showed that the clamping of the suprahdpatic IVC by an abdominal approach was always possible in 84.40% of cases.only in 15.60% cases the intrapericardial clamping IVC by an thoracic approach had to be performed.Clamping of the subhepatic IVC behind the formean epiploicum was possible in 87.50% of cases,ratrohepatic clamping was more advisable in 12.50% of cases.When the right liver was freed in order to display the retrohepatic IVC,the postero-inferior right HV must be cautious.The length of the right HV outside the liver was longer than 10mm in 56.20% of cases,which may be controlled,but the common trunk of the middle and left HV was very frequent (in65.70%)and shorter,extrohepatic control of the middle and left HV was more difficult and more dangerous.The vascular exclusion of the liver must be complte,the right suprarenal vein and the left inferior phrenic vein must be clamped.