肝中静脉的应用解剖学研究

目的观测肝中静脉(Middle hepatic vein MHV)的解剖结构,为病肝切除和活体肝移植(living donor liver transplantation LDLT)提供解剖学基础。方法在78例成人尸体肝膈面沿肝中静脉切开肝实质,显露肝中静脉;对肝中静脉及其属支进行了观测和测量。结果肝中静脉按其属支多少分为3型,l支型75.6%,2支型19.2%,3支型5.2%;肝左、中静脉共干者73%(57例),3支分别汇入者23%(18例),肝左中右静脉共开口1例(3%);肝中静脉注入下腔静脉管径(11.8±2.3)mm,与镰状韧带之间的夹角为(43.04±11.55)°,距膈面的距离(11.14±4.11)mm,总长度(57.8±15.12)mm;肝中静脉属支汇合处的直径(9.61±2)mm,肝中静脉属支的角度(47±17.37)°,肝中静脉属支直径(4.68±1.13)mm。结论对肝中静脉及其属支清晰的解剖学认识对于肝移植及肝切除有着重要意义。

The applied anatomical study of middle hepatic vein

Objective To observe the anatomical structure of the middle hepatic vein(MHV) and provide the anatomical basis for hepatic rejection and living donor liver transplantation.Methods 78 livers were cut along the MHV to expose the MHV and its tributaries for observation and measurement.Results The MHV is divided into three types according to the number of branches,75.6% of the l branch type,19.20% of the 2 branch type,5.2% of 3 branch type.Converged terminal with left and middle hepatic vein happens 73%(57 cases).Three branches import 23%(18 cases) respectively.Converged terminal with left,middle and right hepatic vein is 3%.The diameter of the opening of the terminal of middle hepatic vein which connects inferior vena cava is(11.8±2.3) mm.The angle between falciform ligament and MHV is(43.04±11.55) °.The distance from MHV to the diaphragm is(11.14±4.11) mm.The total length of MHV is(57.8±15.12)mm.The diameter of the branches of the confluence of MHV is(9.61±2.00) mm.The average angle of branches of MHV is(47±17.37) °.The diameter of branches of middle hepatic vein is(4.68±1.13) mm.Conclusion Understanding the clear anatomical structures of middle hepatic vein and its branches is of great significance for liver transplantation and rejection.