肠系膜下动脉的临床解剖

目的：观察肠系膜下动脉分支情况，分析其对结、直肠手术的影响。方法：在结、直肠手术中自肠系膜下动脉根部解剖该动脉及其属支，观察该动脉及其分支、分支吻合情况并测量长度。结果：23例肠系膜下动脉均自腹主动脉发出，14例左结肠动脉单独自肠系膜下动脉发出，7例与乙状结肠动脉共干，2例左结肠动脉缺如。肠系膜下动脉平均长度为（6．8±2．36）cm。其根部至发出第一分支的长度是（3．93±2．62）cm。第一分支与第二分支之间长度为（2．03±1．75）cm。左结肠动脉干长度（2．67±2．07）cm。结论：肠系膜下动脉分支及长度变异大，在结、直肠癌手术中处理不当可能导致转移淋巴结残留，也可能致吻合口血循环不好或形成张力。用带蒂乙状结肠瓣修复阴道时可因血管束张力、血循环不良致肠瓣坏死。

Clinical dissection of inferior mesenteric artery

Objective： To observe the branches of inferior mesentetic artery and analyse the influence on the operation of colon and rectum. Methods： Dissecting the artery and its branches from the root of the artery under mesentery and observing the artery and its branches,meanwhile measuring their length. Results ：Twenty three cases have inferior mesenteric arteries coming from ventral aortas. Among them there are 14 cases who have left colic arteries coming from inferior mesenteric artery alone. And the left colic arteries and arteries of colon sigmoideum of 7 paients are connected with the same truncus arteriosus. There are 2 cases who have no left colic arteries. The average of inferior mesenteric arteries are （6.8 ± 2.36）cm in length. The length from the root to the first branch is （3.93 ±2.62）cm. The length is （2.03±1.75） cm between the first to the second branch. The truncus arteriosus of left colon is （ 2.67± 2.07 ） cm in length. Conclusion： There are many variations in branches and length of inferior mesemteric arteries. Improper treatment may cause the leftover of metastatic lymph nodes, or may cause werse blood circulation of anastomotic place and also may cause strain. When we use the pedicle colon sigmoideum valves to restore the vagina, the colon valves may be necrotic because of werse blood circulation and strain.