右叶部分肝移植的解剖学研究

发布时间：2018-03-01 16:22

本文关键词： 活体肝移植肝脏解剖门静脉肝动脉胆管肝静脉下腔静脉　出处：《第一军医大学》2005年博士论文　论文类型：学位论文

【摘要】：肝移植是治疗终末期肝病公认有效的方法,成人右叶部分肝移植是扩大成人供肝来源的良好途径,因为肝脏解剖结构的复杂性,右叶部分肝移植的应用,尤其是右叶部分活体肝移植在临床上应用受到一定的限制。右叶部分肝移植涉及供肝脏质量的评估、体积或质量的计算,肝动脉、胆管、门静脉、肝静脉和肝短静脉或其分支的解剖、分离、切取与重建,其中任何一个环节成功与否都关系到受者是否能有高质量的生存,对于活体肝供者不仅经历一次较大的身体上创伤,也是经历履行家庭社会责任,承受巨大心理压力、实现个人价值的一次严峻考验。中国为肝病的高发病区,有许多终末期的肝病患者需要肝移植治疗,而供体极为匮乏。本研究从解剖学角度观察肝脏各管道的结构、分布规律,结合右叶肝移植具体术式进行解剖研究,为中国临床上广泛开展右叶部分肝移植,尤其是活体右叶肝移植提供相关的解剖学基础。材料和方法一.41例新鲜肝脏标本,43例非肝病死亡者成人福尔马林固定尸体肝脏标本,91个肝脏铸型标本:观察、统计肝内及肝周的管道的走行、分支、汇合类型、变异情况。二.41例新鲜肝脏标本,43例非肝病死亡者成人福尔马林固定尸体肝脏标本,观测指标:(1)肝静脉的分支数、最大径、长度、肝外长度、走行、汇合、注入IVC管径、注入IVC部位、与IVC角、与镰状韧带夹角、与膈的距离;右后下肝静脉、右后中肝静脉的数目、大小:右上缘支、左上缘支的数量;肝后IVC、肝
[Abstract]:Liver transplantation is recognized as an effective method for the treatment of end-stage liver disease. The adult right lobe partial liver transplantation is a good way to expand the source of adult donor liver, because of the complexity of the anatomical structure of the liver and the application of the right lobe partial liver transplantation. In particular, right lobe partial liver transplantation is limited in clinical application. Right lobe partial liver transplantation involves assessment of donor liver quality, calculation of volume or mass, hepatic artery, bile duct, portal vein, portal vein, hepatic artery, bile duct, portal vein, hepatic artery, bile duct, portal vein, hepatic artery, bile duct and portal vein. The dissection, separation, extraction and reconstruction of hepatic veins and short hepatic veins or their branches are related to the survival of the recipients, and not only to the living liver donors, but also to a larger physical trauma. It is also a severe test of fulfilling family and social responsibilities, enduring tremendous psychological pressure, and realizing personal value. In China, where liver disease is a high incidence area, many end-stage liver disease patients need liver transplantation treatment. In this study, the structure and distribution of hepatic ducts were observed from the anatomical point of view, and the anatomical study was carried out in combination with the specific operation methods of right lobe liver transplantation, so that the right lobe partial liver transplantation could be widely carried out in China. In particular, right lobe liver transplantation in vivo provides anatomic basis. Materials and methods. 41 fresh liver specimens of 43 adult cadaveric liver specimens fixed with formalin and 91 liver cast specimens: observation and statistics of the passage, branch, confluence type and variation of intrahepatic and perihepatic ducts. 2.41 fresh liver specimens and 43 adult cadaveric liver specimens from non-liver dead persons. The number of branches, maximum diameter, length, extrahepatic length, walk, confluence, IVC diameter, and IVC site of hepatic vein were observed by observing the number of branches, maximum diameter, length, extrahepatic length of hepatic vein. Angle with IVC, angle with falciform ligament, distance from diaphragm; number and size of right inferior hepatic vein, right posterior middle hepatic vein: right superior marginal branch, number of left superior marginal branch; posthepatic IVC, liver
【学位授予单位】：第一军医大学
【学位级别】：博士
【学位授予年份】：2005
【分类号】：R322;R657.3

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