胸导管的引流途径与左锁骨上淋巴结肿瘤转移机制探讨

Drainage path of thoracic duct and mechanism of tumor metastasis through left supraclavicular lymph nodes

目的:探讨胸导管的淋巴回流和左锁骨上淋巴结肿瘤转移的机制。方法:⑴在50具成人标本上对左锁骨上淋巴结进行解剖和观察。⑵在49具胎儿尸体和5只犬,用淋巴管间接注射法,解剖胸导管和显色淋巴结。结果:左锁骨上淋巴结以椭圆形为多,占67%,圆形淋巴结占33%。淋巴结数目为(3.88±1.36)个(1￣8个)。左锁骨上淋巴结分为内外侧两部分,内侧部分位于锁骨上三角内,占58.20%;外侧部分位于肩胛舌骨肌下腹与斜方肌前缘之间,占41.80%。胸导管借侧支与周围淋巴结相连。结论:左锁骨上淋巴结主要位于锁骨上三角内,胸导管侧支、淋巴结及其输出淋巴管构成胸导管的侧副淋巴回流经路。

Objective： To explore lymphatic recycle of thoracic duct and the mechanisms of tumor metastasis through left supraclavicular lymph nodes, Methods： 50 adult specimens were anatomized and observed for left supraclavicular lymph nodes, Thoracic ducts were dissected and lymph nodes were colored by indirect injection method in 49 fetus specimens and 5 dogs. Results： Most of left supraclavicular lymph nodes showed oval shape （67%） and round shape （33%）. The number of lymph nodes was about 3.88±1.36 （1-8）. left supraclavicular lymph nodes can be separated into internal and lateral parts. The former （58.20%） located in the supraclavicular triangle, the later in the area between the inferior belly of omohyoid muscle and the front edge of trapezius, with the percentage of 41.80%. Thoracic duct connected with surrounding lymph nodes by its collateral branches. Conclusions： Lef supraclavicular lymph nodes mostly locate in the supraclavicular triangle, and the path of collateral recycle of thoracic duct consist of collateral branches of thoracic duct, lymph nodes and its efferent vessels.