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脾叶动脉影像学解剖和腹腔镜下脾脏大体解剖的临床应用研究

发布时间:2018-04-23 03:37

  本文选题:脾叶动脉 + DSA ; 参考:《山东大学》2005年硕士论文


【摘要】:目的:通过对脾叶动脉DSA影像解剖及脾叶动脉相关的腹腔镜下解剖观察,对脾叶动脉影像解剖进行归纳描述,积累脾叶动脉详实影像学解剖资料;以其为基础,结合脾叶动脉相关的腹腔镜下解剖观察,研究腹腔镜脾切除术时脾蒂血管的最佳处理方式,并探讨腹腔镜治疗需行部分性脾栓塞术脾脏疾病的可行性。 方法:选择非脾脏疾病患者52例,采用Seldinger技术,经股动脉途径插管行脾动脉造影,采集脾动脉正位DSA资料。进行脾动脉在脾门处分支类型、脾叶动脉分支类型的归纳;脾动脉末段内径、脾叶动脉内径、脾叶动脉长度的测量。另选择完全腹腔镜脾切除30例,术时对脾切迹分布、脾叶动脉阻断后脾供血界面变化、脾叶动脉处理方式进行观察并做相关分析。 结果:本组52例脾动脉正位DSA资料中,脾动脉在脾门处分支类型:分散型46例,占88.5%;集中型6例,占11.5%;其他0例,以分散型占优势,与传统资料相比较无统计学差异(P0.05)。脾动脉末段内径最大7.8mm,最小4.8mm,平均6.37±0.59mm,远小于大号钛夹夹闭范围(12.5mm)。脾上叶动脉内径最大4.7mm,最小2.9mm,平均3.96±0.41mm;脾下叶动脉内径最大4.2mm,最小2.3mm,平均3.23±0.44mm,远小于中号钛夹夹闭范围(8.8mm)。脾叶动脉最长66.2mm,最短21.5mm,平均44.7±9.64mm,因此术中易于分出20~40mm血管结扎、夹闭。脾叶动脉分支类型:一支型0例;二支型42例,占80.8%;三支型10例,占19.2%;多支型0例。30例LS观察脾切迹分布:脾
[Abstract]:Objective: to summarize and describe the image anatomy of splenic lobe artery by DSA image anatomy and laparoscopic anatomic observation of splenic lobe artery, and to accumulate detailed anatomical data of splenic lobe artery. Combined with laparoscopic anatomical observation related to splenic lobe artery, the optimal management of splenic pedicle vessels during laparoscopic splenectomy was studied, and the feasibility of laparoscopic treatment of splenic diseases requiring partial splenic embolization was discussed. Methods: 52 cases of non-splenic diseases were selected. Splenic arteriography was performed through femoral artery intubation with Seldinger technique. The positive position DSA data of splenic artery were collected. The types of branches of splenic artery at splenic hilum and branches of splenic lobe artery were summarized, and the internal diameter of splenic artery at the end of splenic artery, the internal diameter of splenic lobe artery and the length of splenic lobe artery were measured. In addition, 30 cases of total laparoscopic splenectomy were selected. The distribution of splenic incisors, the changes of splenic blood supply interface after splenic artery occlusion, and the treatment of splenic lobe artery were observed and analyzed. Results: in 52 cases of splenic artery, the branch type of splenic artery in the splenic porta was divided into 46 cases (88.5%), 6 cases (11.5%), and 0 cases (0 cases), with no statistical difference compared with the traditional data (P 0.05). The internal diameter of the splenic artery was 7.8mm and 4.8mm, with an average of 6.37 卤0.59mm, which was much smaller than that of the large titanium clamping area (12.5mm-1). The internal diameter of superior splenic lobe artery was 4.7mm, the smallest was 2.9mm, the average was 3.96 卤0.41mm, and that of inferior lobe artery was 4.2mm, 2.3mm and 3.23 卤0.44mm, which was much smaller than that of medium titanium clip. The longest 66.2 mm, the shortest 21.5 mm, the average 44.7 卤9.64 mm of splenic lobe artery, so it is easy to separate out the 20~40mm blood vessel ligation, clipping. The type of branches of splenic lobe artery: one branch in 0 cases; two branch type in 42 cases (80.8%); three branch type in 10 cases (19.2%); multiple branch type in 0 cases (.30 cases) LS was used to observe the distribution of splenic notch:
【学位授予单位】:山东大学
【学位级别】:硕士
【学位授予年份】:2005
【分类号】:R657.6;R322

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