A型主动脉夹层头臂血管的解剖学研究及临床意义

发布时间：2018-04-10 03:33

本文选题：主动脉形态　切入点：主动脉夹层　出处：《中国临床解剖学杂志》2016年06期

【摘要】：目的对A型夹层状态下的头臂血管进行解剖学测量,为人工血管的制作和完善提供数据支持,为主动脉腔内治疗和头颈部介入操作提供参考。方法对331例A型主动脉夹层的患者行回顾性CTA三维重建,并对其分别进行形态描述,径线和角度测量。结果共计331例,标准型主动脉弓91.5%(303例),变异型主动脉弓8.5%(28例)。25.4%(77例)3分支开口均低于主动脉弓最高点。3分支开口分布中,IA多见于后位,而LCCA和LSA则多见于中位。IA最易被夹层累及。由IA到LSA,3分支在开口处的直径分别为(16.2±3.6)、(11.0±3.3)、(12.9±3.6)mm。3分支在距离开口2 cm处直径分别为:(12.0±3.0)、(9.0±1.9)、(9.8±2.1)mm。IA-LCCA间距平均为(10.1±5.5)mm(2.0~20.0mm)。LCCA-LSA间距平均为(14.1±5.9)mm(2.0~27.0mm)。在主动脉弓冠状面,头臂血管与主动脉弓所成角分别为(62.5±26.5)°,(57.8±23.4)°,(64.9±23.5)°。在主动脉弓横截面,头臂血管与主动脉弓所成角分别为(121.1±24.7)°,(107.3±19.4)°,(100.5±16.1)°。结论通过本研究得到了A型夹层状态下的头臂血管详细解剖数据,且和目前流行的人工血管设计数据并不一致,这为人工血管进一步完善提供了数据支持。
[Abstract]:Objective to measure the anatomy of head and arm vessels in type A dissection, to provide data support for the fabrication and improvement of artificial vessels, and to provide reference for endovascular treatment of aorta and interventional operation of head and neck.Methods three dimensional CTA reconstruction was performed in 331 patients with type A aortic dissection, and the morphologic description, diameter and angle were measured.Results there were 331 cases with standard aortic arch (91.5) and 303 cases with variant aortic arch (8.5g / kg). In 77 cases with variant aortic arch (8.5g / kg), the third branch opening was lower than that at the highest point of aortic arch (3.3branches) in posterior position, while LCCA and LSA were more likely to be involved by dissection in middle position (.IA).The diameter of the branches from IA to LSA-3 at the opening was 16.2 卤3.6m (11.0 卤3.3mm) and 12.9 卤3.6)mm.3 (12.0 卤3.0cm) from the opening to the opening, respectively. The diameter of the branches from IA to LSA-3 was 9.0 卤1.9 卤1.90 卤1.89 卤2.1)mm.IA-LCCA, respectively, and the average distance between them was 14.1 卤5.9mm ~ 2.0mm ~ 27.0 mm ~ (-1).On the coronal plane of aortic arch, the angle between the vessels of the head and arm was 62.5 卤26.5 掳and 57.8 卤23.4 掳respectively.In the cross section of aortic arch, the angle between the vessels of the head and arm and the aortic arch was 121.1 卤24.7 掳and 107.3 卤19.4 掳/ 100.5 卤16.1 掳respectively.Conclusion the detailed anatomical data of cephalic and brachial vessels in type A dissection were obtained in this study, which were not consistent with the prevailing design data of artificial blood vessels, which provided data support for further improvement of artificial blood vessels.
【作者单位】：中国医学科学院阜外医院心外科;
【分类号】：R322.1

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