十二指肠降部的解剖学特点及临床意义

目的　为内镜诊治十二指肠降部疾病及减少医源性损伤提供应用解剖学。 方法　40例福尔马林固定成人尸体标本，解剖观测十二指肠降部的外形、长度，大乳头的形状、位置以及上曲、下曲、大乳头处的内周径、外周径、肠壁厚度。 结果　十二指肠降部的外形有竖直形、弧形和不规则形，多为上细下粗，且大部分标本有狭窄，狭窄处肠腔内黏膜为纵形皱襞、稀疏低矮环形皱襞或平坦无皱襞。十二指肠降部长度为(8.2±1.9)cm；上曲、下曲、大乳头处的肠腔内周径分别为(4.8±1.7)cm、(5.8±1.3)cm、(6.9±2.3)cm；肠管外周径分别为(7.0±1.3)cm、(8.8±1.2)cm、(9.2±1.6)cm；内侧肠壁厚度分别为(2.29±0.63)mm、(1.91±0.49) mm、(1.75±0.73)mm；外侧肠壁厚度分别为(1.63±0.53) mm、(1.42±0.37)mm、(1.54±0.40) mm。十二指肠大乳头的形状多变，与上曲的距离为(4.3±1.9)cm。 结论　行内镜检查和治疗十二指肠降部疾病时，掌握和认真观察其解剖学特点，对寻找病变部位及减少医源性损伤有重要意义。

Anatomic features and clinical significance of the descending duodenum

Objective To provide applied anatomic data for the diagnosis and treatment of the descending duodenal diseases and reducing iatrogenic endoscopic injury.Methods Forty adult cadaveric specimens fixed with formalin were dissected.The shape and the length of descending duodenum,the shape and location of major duodenal papilla,and the inner diameter,outside diameter,wall thickness at the superior,inferior flexure duodenum and major duodenal papilla were observed respectively.Results The descendent duodenum shap...