摘要
目的探讨肝脏第IX段临床应用解剖及其占位性病变的介入治疗。方法对50例肝脏进行解剖观察;对6例肝脏第IX段占位性病变进行介入栓塞化疗。结果肝脏第IX段动脉主要来源于肝右动脉,部分来自肝中动脉或肝左动脉;门静脉主要来自门静脉右前叶上段支,小部分来自门静脉左支横部;胆管汇入右肝管;静脉血由数支细小静脉经第3肝门直接汇入肝后下腔静脉,部分汇入肝右静脉。第IX段肝脏肿瘤通过血管介入治疗后,肿瘤显著缩小;其中4例合并黄疸患者肝功能明显缓解。结论肝脏第IX段是一个结构上较为独立的区域,有其特殊的管道系统和引流系统,位置深隐,单独或联合手术切除较困难;通过介入技术可以对该区段进行相应的治疗。利用微导管采用超选技术,可以对肝脏第IX段的病变进行精确的治疗,微创、副作用小、可重复操作,能够弥补外科手术的局限性,达到甚至超过外科手术的治疗效果。
Objective To study applied anatomy of the liver segment IX and explore interventional therapy of hepatoma in segment IX.Methods Anatomic features of segment IX were performed on 50 liver specimens,while,6 cases with primary hepatocullar carcinoma were embolized with overliquefied iodine-oil admixed with mitomycin,epirubicin and fluorouracil.Results Arteries of segment IX mainly originated from the right hepatic artery,and partly from the hepatic medial or left arteries.The branches of its portal vein came chiefly from the right anterior superior PV,and partly from the transverse part of the left PV,its bile duct drained into the right bile duct,while the drainage vein of the segment IX flowed into the inferior cava vein through the third porta hepatis,and partly into the right hepatic vein.The tumors within the segment IX became smaller and the liver function relieved obviously after intervene embolization.Conclusions The liver segment IX,which located deeply and latently in the liver,is a relative independent region with special vessels and draining duct systems.It is difficult to perform tumor incision in this region through separated or combined way.The embolization of the artery vessels with intervene technique was feasible and effective for the tumor treatment within the segment IX.Introduced with microcatheter by Seldlinger technique,tumors located deeply in special regions of the liver such as the segment IX could be treated availably.The intervene embolization and chemotherapy could be applied repeatedly for treating liver carcinoma with micro-wound and less complication which could not be treated by operational hepatectomy in some special region.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2010年第5期500-503,共4页
Chinese Journal of Clinical Anatomy
关键词
肝第IX段
临床应用解剖
肿瘤
介入栓塞化疗
Liver segment IX
Applied anatomy
Tumor
Iintervene embolization chemotherapy
