胎儿和新生儿肾上腺的血管构筑

本文采用血管复型扫描电镜,注射墨汁切片光镜下观察和注射铅丹乳胶X线照像3种方法,研究了28例胎儿和新生儿肾上腺的血管构筑。发自膈下动脉、腹主动脉和肾动脉的肾上腺上、中、下动脉及其分支,在肾上腺囊表面和穿过囊的过程中逐级分支,最后形成毛细血管。动脉和毛细血管共同构成囊血管丛,从该丛发出的皮质动脉和髓质动脉,分别分支供给皮质和髓质。从囊血管丛发出的“V”型动脉在皮质中行一段距离后又返回囊中分支。永久性皮质毛细血管网是囊毛细血管的直接延续。在胎儿性皮质中,毛细血管有两个来源,其一是永久性皮质毛细血管的延伸;另一来源是由皮质动脉分支构成。它们共同构成胎儿性皮质毛细血管网。在胎儿性皮质的中部,毛细血管汇成小静脉。中央区的髓质由髓质动脉供血。在皮质中,正在迁移的髓质细胞团由与之伴行的动脉供应。在皮质中形成的小静脉呈向心性行走。其中一部分在近中央区又分为毛细血管,这些毛细血管相互吻合,最后入中央静脉的属支中。这种分布特点属于门脉形式的血管;另一部分属于中央静脉的第一级属支,它们逐级汇合后形成中央静脉主干。中央静脉系呈树枝状,其主干在腺的前面穿出腺后为肾上腺静脉。左侧肾上腺静脉人左肾静脉;右侧的人下腔静脉。而与动脉伴行的肾上腺上、中、下静脉的末级属支与囊毛细血管相连。本研究讨论了胎儿和新生儿肾上腺血管的分布规律,为胎儿内分泌学和肾上腺移植等方面提供了血管形态学基础。

THE VASCULAR ARCHITECTURE OF THE ADRENAL GLAND IN THE FETUSES AND NEWBORNS

The blood vessels of the adrenal gland of 28 fetuses and newborns were studied in this work. Three methods, the injection replication of the microvasculature for scanning electron microscopy, the injection of ink for light microscope and lead latex injection for gross anatomy, have been used. The superior, middle and inferior arteries of the adrenal gland originate from the inferior phrenic artery, abdominal aorta and renal artery respectively. They branch into fin- er arteries when they reach the surface of the gland and run through the capsule of the gland. The finer arteries divide into branches beneath the capsula of the gland. Some of the ultimate branches divide into capillaries and form the subcapsular plexus proper. Others enter directly into the adrenal cortex and medulla separately. They are named the cortical arteries and medullary arteries. Looped cortical arteries run into the cortex from subcapsular plexus, and return to the subcapsular plexus and supply it with blood. We call them the "V" type arteries. The subcapsular plexus gives off numerous capillaries that form the adult cortical capillary plexus which supplies, in turn, the fetal cortex capillaries with blood. The cortical arteries give off the capillaries to supply blood to the fetal cortex. These two kinds of the capillaries form the fetal cortical capillary plexus. In the middle of the fetal cortex the capillaries converge into small veins which run centripetally. Some of them form the first order branch of the central vein. Others break up into the capillaries near the central region. These capillaries converge into the small venous channels which drain into the central vein. This form of vessels is named the "portal vessels". Medullary cells migrating in the cortex are supplied with blood by the medullary arteries proper. The small veins converge gradually to form a treelike pattern and finally drain into the central vein which emerges as the adrenal vein on the anterior surface of the gland. The right adrenal vein drains into the vena cava inferior and the left one into the renal vein. Adrenal arteries are accompanied by the corresponding veins. The superior adrenal vein drains toward the inferior phrenic vein. The middle adrenal vein drains into the adrenal vein, and the inferior one into the renal vein.