左肺门支气管和血管在横断面上的配布特点

目的：探讨左肺门支气管和血管在横断面上的配布特点。方法：在44例成人胸部连续横断层标本和10例多层螺旋CT图像上，追踪观察了左侧第1、2、3肺门处支气管、肺动脉和肺静脉的分支（或属支）及其毗邻关系。结果：在气管权层面上，尖后段静脉居中，其前方，前段动脉居前段支气管的内前方；其后方，尖后段动脉上行于相应支气管内侧。在肺动脉权层面上，左肺动脉发出尖后段动脉和前段动脉，其外侧可见尖后段支气管和前段支气管。在27例（61、4％）断层标本上，左肺动脉与前段动脉一起呈“鱼钩”状勾绕左上肺静脉。在左肺上叶支气管层面上，左肺上叶支气管居中，其前方，前段静脉汇入左上肺静脉；其后方，上段动脉发自左肺下叶动脉。在左肺下叶支气管层面上，上段支气管发出。于上叶内，下舌段支气管居中，其前方，舌静脉干汇入左上肺静脉；其后方，舌动脉干发自左肺下叶动脉。在底段上、下静脉层面上，内前、外侧和后底段支气管呈顺时针排列，各底段动脉相对同名支气管呈周围性分布，底段上、下静脉呈向心性走行。结论：通过寻找标志性结构，在横断面上可准确识别左肺肺段和亚肺段的支气管、肺动脉和肺静脉。

Bronchovascular anatomy of left pulmonary hilum on the transverse section

Objective:To explore the anatomic characteristics of the bronchi, arteries, and veins of left pulmonary hilum on the transverse section. Methods: Using serial transverse sections of thorax of 44 adult cadavers and multislice spiral CT images of 10 healthy volunteers, the segmental and subsegmental bronchi, arteries, and veins of left lung were traced. Their anatomic relationships were also evaluated. Results:On the section through tracheal bifurcation, in front of the apicoposterior segmental vein, anterior segmental artery lay medioanterior to anterior segmental bronchus. Behind the apicoposterior segmental vein, apicoposterior segmental artery ascended inside its corresponding bronchus. On the section through bifurcation of pulmonary trunk, apicoposterior and anterior segmental arteries arised from left pulmonary artery. The apicoposterior and anterior segmental bronchi lay on the lateral side of left pulmonary artery. On the sections of 27 cadavers (61.4%),left pulmonary artery and anterior segmental artery which together like a fishhook drew left superior pulmonary vein. On the section through left superior lobar bronchus, left superior lobar bronchus lay in the center. Before it, anterior segmental vein converged into left superior pulmonary vein. Behind it, superior segmenta1 artery arised from left inferior lobar artery. On the section through left inferior lobar bronchus, superior segmenta1 bronchus appeared. In the superior lobe, the inferior lingular bronchus can be cut. Before it, lingular venous trunk converged into left superior pulmonary vein. Behind it, lingular arterial trunk arised from left inferior lobar artery. On the section through superior and inferior basal veins, medioanterior, lateral and posterior basal bronchi arranged clockwise. The basal segmental arteries lay toward the periphery relative to their corresponding bronchi, the segmental veins lay centrally to their corresponding bronchi. Conclusions: The segmental and subsegmental bronchi, arteries, and veins of left lung can be recognized correctly on the transverse sections by finding landmark structures.