摘要
目的:观察经手术治疗的胃癌患者在体胃裸区的形态、内部结构及与周围解剖间隙存在的通联。方法:选择2006年1月-2011年9月在川北医学院附属第二医院住院治疗的胃癌患者共60例,根据术前螺旋CT诊断,分为胃裸区受到侵犯(A组)和未受到侵犯(B组)各30例,使用亚甲蓝和抗癌药物配制成的混合液作为染色剂,手术中切开胃结肠韧带、脾胃韧带后游离至胃裸区下界,轻提胃壁向胃裸区内注射染色剂,观察胃裸区与周围解剖间隙的通联关系,尤其是有与右侧相通联。分离切开胃裸区周围韧带,游离至食管下端,切去食管下端近肿瘤侧食管,显露出被着色的胃裸区平面,观察胃裸区形态及裸区内走形的血管、神经及其走向和分支、裸区内淋巴结的数目及淋巴液的流向。使用游标卡尺测量其周长和其长、宽。结果:(1)在体胃裸区出现率为100%,形态不规则,A组胃裸区大部分近似椭圆形、小部分形似长方形,周长为(17.86±3.58)cm、长(4.96±0.72)cm、宽(3.77±0.51)cm,面积为(13.15±2.25)cm2;B组胃裸区大部分形似长方形、小部分形似椭圆形,周长为(15.66±3.68)cm、长(4.91±0.92)cm、宽(3.02±0.49)cm,面积为(10.75±3.28)cm2;(2)两组患者胃裸区左右侧界均为胃、膈韧带左、右层,左侧与左肾周间隙相通、右侧封闭、上界与膈下腹膜外间隙相通,并通食管裂孔和膈血管间隙与纵隔相连、向下与肾旁前间隙相通联;(3)A、B两组胃裸区内有血管分布的占100%,其中只有胃左动静脉占13%,只有胃后动静脉分布的占60%,只有膈下动脉返支的占10%,有胃左动静脉和胃后动静脉分布的占9%,有胃后动静脉和膈下动脉返支的占5%,同时有胃左动静脉、胃后动静脉和膈下动脉返支的占3%;A、B两组胃裸区有淋巴结分布的占100%,出现的淋巴结均为胃左淋巴结,有1～3枚淋巴结的占82%,有3～5枚淋巴结的占15%,有5枚以上淋巴结的占3%;A、B两组胃裸区�
Objective：Observing the form,internal structure and connection surrounding of the stomach bare area in the surgical treatment of stomach cancer patients.Methods：Choosing 60 stomach cancer patients in the second affiliated hospital of north Sichuan medical college,randomly dividing into A group and B group.In operation,cutting the stomach colon ligament,the spleen stomach ligament,reaching the lower bound of the stomach bare area,slightly injecting the colouring agent into the stomach bare area,observing the connection surrounding of the stomach bare area.Separately cutting the ligament surrounding of the stomach bare area and the tumor near esophageal,reaching the surface of the stomach bare area,observing the form,internal structure,blood vessels,nerve,lymph nodes.measuring its length and width.Results：（1）The stomach bare area appears rate was 100%,the form irregular,in group A,the stomach bare area most approximate oval,like a rectangle,circumference is（17.86±3.58）cm,long is（4.96±0.72）cm,wide is（3.77±0.51）cm;the area is（13.15±2.25）cm2;in group B,the stomach bare area most like a rectangle,similar to the oval,circumference is（15.66±3.68）cm,long is（4.91±0.92）cm,wide is（3.02±0.49）cm,the area is（10.75±3.28）cm2.（2） In the two groups,left and right sides of the stomach bare area are stomach,diaphragmatic ligament,left with her left kidney weeks clearance interlinked,the right upper bound closed,and under the diaphragm peritoneal gap are interlinked,and the combination relationship of mediastinal through the esophageal stage and vascular clearance,reaching the gap before kidney downward phase.（3） A,B two groups in the stomach bare area with vascular 100%,of which only left gastric arteriovenous 13%,only the stomach vein 60%,only artery branch of the diaphragm 10%,left gastric arteriovenous and stomach after moving vein 9%,stomach after moving vein and artery branch of the diaphragm 5%,left gastric arteriovenous,stomach after moving vein and artery branch of the
出处
《医学理论与实践》
2012年第16期1933-1934,1937,共3页
The Journal of Medical Theory and Practice
基金
四川省2011年第二批科技计划项目(应用基础研究项目)(编号:2011JY0116)
关键词
在体胃裸区
胃癌
亚甲蓝
解剖间隙
通联关系
The stomach bare area
Stomach cancer
Methylene blue
Anatomical gap
Connection relationship
