肝蒂内结构肝内分支的形态观测及临床意义

目的研究肝蒂内结构在肝内的分布状况,对肝叶及肝段进行量化分析;探讨肝脏手术时血管和胆管的保护及定位标志,为相关临床科室手术提供解剖学依据。方法取20例无肝病死亡后的人体肝脏标本及肝脏铸形标本,用游标卡尺和三角尺等进行有关数据的测量,所的数据用SPSS10.0软件进行统计学分析。结果肝蒂内结构入肝实质后三者以肝门静脉分支为主轴,攀附伴行。门静脉大多分为左、右干,部分右干缺如,且右干变异较大,肝管汇合方式常见为3型。结论肝脏血管丰富,解剖结构复杂,出血难以控制。肝脏的分叶与分段对于肝脏手术具体方式有指导作用。每一肝段都有它的单独管道系统,可以作为一个外科切除单位。

The morphology observation and clinical significance of the hepatic pedicle structure''''s intrahepatic branches

Objective To study the distribution of hepatic pedicle structure within liver, in progress to analyses lobus hepatis and segmenta hepatis; discuss the position and marker of the blood vessel and bile duct being protected in liver operation, provide anatomical basis to clinic. Methods The interested data of corpse livers without pathological changes were measured with the verniercalipers and ruler oftriangle. The outcomes were analyzed with SPSS 10.0 software. Results The structures within the hepatic pedicle accompanied with each other along the branches of the hepatic portal vein. Most of the hepatic portal vein divided into left and right trunk, and right trunk showed larger anatomic variations,The hepatic duct confluens in three different way. Conclusions Liver surgery has high-risk and grasps difficult, the main causes are profuse blood vessels, complex anatomical structure, difficulties on bleeding control. Lobus hepatis and segmenta hepatis have directive significance on choosing operation path way. Each segment has its own separate pipeline system which can be used as a surgical resection unit.