中国人气管的动脉

THE BLOOD SUPPLY OF THE TRACHEA IN CHINESE

本文观察了成人、儿童、婴儿共100例气管的动脉。恒定者发自甲状腺下动脉、支气管动脉、甲状腺上动脉与食管动脉;不恒定者发自锁骨下动脉(14.5%±3.52)、甲状腺最下动脉(12%±3.25)、肋颈干或最上肋间动脉(8.5%±2.79)、胸廓内动脉(6.5%±2.47)与椎动脉(2.5%±1.56);个别发自甲状颈干(1%±0.99)、无名动脉(100/±0.99)与主动脉弓、右甲状腺下浅动脉或右肩胛上动脉(各0.5%±0.71)。成人管径为0.2~2.1毫米,0.6毫米以上的占半数以上。节段性气管支在气管外侧蒂经过中,大多分成气管动脉与食管动管。对气管动脉的行程及其与喉返神经和右迷走神经的位置关系进行了观察。气管周围动脉吻合丰富,节段性气管动脉沿气管外侧壁上、下连成气管外侧纵链,管径为0.1~0.5毫米,出现率为63.3%±8.80,借前软骨间横动脉以调节左、右侧血液循环。气管支在气管外侧蒂中,上下连成气管旁纵形吻合,以加强气管外侧纵链的侧支循环。在气管膜壁,后软骨间横动脉与气管动脉、食管动脉的膜壁支上下连成网状吻合。在甲状腺与气管上端周围的动脉互相形成丰富吻合,补充气管颈段的血液循环。气管胸段,支气管及气管支气管淋巴结周围的动脉形成广泛的吻合,以补充气管胸上段动脉与支气管动脉间的侧支循环。本文对气管动脉的形态特点、经过、分布及其与临床应用的意义进行了讨论。

The blood supply of the trachea was studied in 100 Chinese cadavers.The trachea is supplied constantly by the inferior thyroid,the bronchial,the superior thyroid and the esophageal arteries,inconstantly by the subclavian(14.5%±3.52),the thyroidea ima(12%±3.25),the costocervical trunks or the superior intercostal(8.5%±2.79),the internal thoracic(6.5%±2.47),the vertebral(2.5%±1.56)and rarely by the thyrocervical trunks(1%±0.99),the innominate(1%±0.99),the aortic arch(0.5%±0.71),the right superficial inferior thyroid(0.5%±0.71)or the right suprascapular artery(0.5%±0.71).The diameters of the tracheal arteries in the adult ranged from 0.2 to 2.1 mm and more than 50%of them exceeded 0.6mm.On passing through the lateral pedicles of the trachea,the segmental tracheal branches divide frequently into tracheal and esophageal arteries.The course of the tracheal arteries and their relations with the recurrent laryngeal nerves and the trunk of the right vagus nerve were observed.There are abundant arterial anastomoses around the trachea.The segmental tracheal arteries branch and run upward and downward on the lateral aspects of the trachea,and connect with the tracheal arteries from above and below.A lateral longitudinal anastomosis of 0.1~0.5 mm in diameter was found in 63.3%±8.80 of 30 cases.Arising from the lateral longitudinal anastomoses,the intercartilaginous arteries of both sides run anteriorly and medially,anastomose with each other and establish anteriorly a collateral circulation between two sides of the trachea.In the lateral pedicles the tracheal branches connect with the branches from above and below to form the paratracheal longitudinal anastomoses,enforcing the collateral circulation of the lateral longitudinal anastomoses.The posterior tracheal wall is supplied by the posterior transverse intercartilaginous arteries and the membranous twigs,which derive from the tracheal and esophageal arteries.They form a netlike anastomosis from one level to another in the posterior tracheal wall.The rich anastomoses in and around the thyroid gland and the upper end of the trachea supplement the circulation to the cervical trachea.The wide anastomoses around the thoracic trachea,extra-pulmonary bronchi and the paracarinal nodes supplement the collateral circulation between the arteries of the upper thoracic trachea and the bronchial arteries.The clinical importances of the topographical characteristics,the course and distribution of the tracheal arteries were discussed.