摘要
根据小肠代食管手术设计的要求,解剖并测量了50例成年尸体的小肠血管、胸廓内血管和甲状腺上动脉。1.小肠动脉小肠动脉的支数平均为5.4支。小肠动脉的管径为1.5~10.0毫米,3毫米以上的占半数以上。第1~6小肠动脉的平均长度为25~45毫米,30毫米以上的占半数以上。其中以第3小肠动脉最长(45毫米),管径也较大(4.0毫米),是较为理想的吻接动脉。小肠动脉有22%出现短干。短干的分支中,都有1~2支较长且粗,手术中可当作一个小肠动脉加以利用。小肠动脉弓的级数平均2.7级。第1、2级动脉弓的管径都较粗大;第3级弓以下的管径在0.9毫米以下的较多。故手术中展直小肠时,以保留第二级弓为宜。2.小肠的长度空回肠的总长度为531厘米(328~765)。小肠动脉所分布的肠管长度,由第1小肠动脉至第8小肠动脉是逐渐增加的(37~253厘米)。在空肠上段,保留有代偿能力的、管径在1.0毫米以上的动脉弓,剪断肠系膜,展直肠袢,每展直1厘米,所对应的肠管为2.6厘米。3.小肠静脉平均支数为2.9支(1~5),比动脉少。一个小肠静脉往往与两个以上的动脉相对应,它的第1级属支基本上与动脉伴行。4.甲状腺上动脉在动脉分支前测量了管径,左侧为3.1毫米,右侧为2.8毫米。甲状腺上动脉是受区较为理想的一个吻接动脉。5.胸廓内血管胸廓内动脉在第二、三肋间的管径平均为2.6~2.8毫米。静脉的管径平均为2.4~3.1毫米。胸廓内动脉的管径与小肠动脉很接近,但静脉的管径显得细小。因此,胸廓内动脉是小肠代食管手术中的理想备用吻接动脉。但受区的静脉则以选用管径较粗的颈外静脉或颈前静脉为宜。
For the purpose of offering data for reference to surgical replacement of the esophagus,the vessels of the small intestine,the internal thoracic and the superiot thyroid arteries of 50 adult cadavers were dissected and their lengths and diameters were measured.1.There were an average of 5.4 arteries supplying the small intestine,their diameters ranged from 1.5 to 10.0mm and more than 50%of them exceeded 3.0mm.The average length from the 1st to 6 th intestinal arteries ranged between 23.5 to 45.5mm and more than 50%of them exceeded 30.0mm.The 3rd intestinal artery was the longest(averaged 45.5mm)with larger lumen,an ideal one for anastomosis.22%of the arteries appeared as short trunks,at least one or two of their branches was suitable in length and size for utilization during operation.The average grading of tile arterial arches of the small intestine was 2.7 grades.The lumens of the arterial arches of the 1st and 2 nd grades were larger than those of the 3 rd grade and the rest,the jority of the latter were smaller than 0.9 mm in diameter.Therefor,the preservation of the 2 nd grade arterial arch will be important during the dissection of the small intestine.2.The average total length of the jejunum and ileum was 530.6 cm(ranged from 328.0 to 765.0cm).The segments of the small intestine supplied by individual intestinal arteries increased its length gradually from the 1st to the 8 th.The preservation of the arterial arches of a calibre 1.0 mm in diameter with their collateral circulation intact is of great importance at the upper part of the jejunum.The proportion of the lengths of straightened mesentery to that of the straightened,,intestinal loop was 1:2.6.3.The number of the intestinal veins averaged 2.9 branches which was less than that of the arteries.The approximate ratio o7 the numbers of veins to arteries was 1 to 2,and usually the 1st branch of the vein accompanied the artery.4.The average diameter of the superior thyroid arteries before branching measured 3.1 mm on e left and 2.8 mm on the right,and was
作者
陶永松
钟世镇
Tao Yongsong;Zhong Shizhen(Department of Anatomy,the First FLA Medical College)
出处
《解剖学报》
CAS
1981年第3期225-234,共10页
Acta Anatomica Sinica
