肺段和亚肺段支气管和血管的冠状断层解剖学研究

目的研究肺段和亚肺段支气管、肺动脉和肺静脉在冠状断面上的配布规律。方法利用加例胸部连续冠状断层标本和4例成人胸部多层螺旋CT图像，追踪观察肺段和亚肺段支气管、肺动脉和肺静脉。结果在冠状断面上有6个识别肺段和亚肺段支气管和血管的关键层面：1．升主动脉层面，切及尖段静脉、后段静脉、外侧段静脉、尖后段静脉、前段静脉和上舌段静脉；2．肺动脉权层面，于肺动脉权或左肺动脉下方可见到左、右上肺静脉注入左心房，在ll例（55％）标本中出现尖后段静脉、前段静脉和舌静脉干同时汇入左上肺静脉的情形；3．气管权层面，于气管权下方可见到左、右下肺静脉汇入左心房；4．中间支气管层面，可见到两肺下叶肺段支气管、肺动脉和肺静脉的起源；5．胸主动脉层面，主要为两肺上段和外后底段的支气管和血管；6．脊柱层面，两肺下叶主要表现为上段、外侧底段和后底段的支气管和血管。结论在胸部冠状断面上，以支气管分支为向导可准确辨认肺段和亚肺段的肺动脉和肺静脉。

SEGMENTAL AND SUBSEGMENTAL BRONCHOVASCULAR ANATOMY OF THE LUNGS ON THE CORONAL PLANE

Objective To explore the anatomic characteristics of the bronchi,arteries,and veins of pulmonary segments on the coronal section.Methods Using serial coronal sections of thorax of 20 adult cadavers,multislice spiral CT images of 4 healthy volunteers,the segmental and subsegmental bronchi,arteries,and veins were traced and observed.Results There are 6 key sections for recognition of the segmental and subsegmental bronchovascular structures of the lungs on the coronal section:1.On the section through ascending aorta,the apical,lateral,apicoposterior,anterior,and superior lingular segmental veins appeared.2.On the section through pulmonary bifurcation,the left and right superior pulmonary veins can be seen under the pulmonary bifurcation.It appears on the coronal sections of 11 cadavers(55%) that apicoposterior segmental vein,anterior segmental vein,and lingular venous trunk drained into left superior pulmonary vein simultaneously.3.On the section through bifurcation of trachea,left and right superior lobar bronchi and their branches are demonstrated clearly.Under the bifurcation of trachea,it can be seen that left and right inferior pulmonary veins empty them into left atrium.4.On the section through intermediate bronchus,the origins of segmental bronchi,arteries,and veins of inferior lobes of bilateral lungs can be found.5.On the section through thoracic aorta,superior segmental and lateroposterior basal segmental bronchovasclature appeared mainly.6.On the section through spinal column,the inferior lobes of bilateral lungs shows the bronchi,arteries,and veins of superior,lateral basal,and posterior basal segments mainly.Conclusions The pulmonary segmental arteries and veins can be recognized exactly by tracing bronchi carefully on the coronal section.