肝动脉解剖变异及其临床意义

The anatomic variations of hepatic Artery and its clinical significance

目的总结肝动脉变异发生率、性别差异及变异分型,提高对变异肝动脉的认识,指导临床进行准确的诊疗。方法通过查阅文献、观察解剖实验室标本、回顾我校第二临床医学院近年开展的数字减影及CT血管成像资料,分析肝动脉起源和动脉走行分布情况等解剖特征,按起源分布进行分类统计变异发生率及确定变异类型。结果正常型(肝总动脉起源于腹腔干)7123例,占77.27%。变异的肝动脉2095例,占22.73%。其中起源于肠系膜上动脉(SMA)1031例,占11.18%;起源于胃左动脉(LGA)787例,占8.54%;起源于肠系膜上动脉+胃左动脉的87例,占0.94%;起源于腹主动脉32例,占0.35%;起源于腹腔干+肠系膜上动脉30例,占0.32%;起源于腹腔干和腹主动脉58例,占0.63%;起源于胃十二指肠15例,占0.16%;其余各类起源复杂罕见,共55例,占0.60%。结论肝动脉变异种类繁多复杂。男性肝动脉变异比女性高。根据起源分型变异肝动脉,对于临床医生加深对变异肝动脉的认识有重要意义。

Objective Investigate variations of hepatic artery anatomy, to provide effective clinical sub-standard of variant hepatic artery. Methods Through four material （Literature review, hepatic arterial DSA data, generally anatomical specimens, and angiography information of CTA）, we retrospectively summarized the hepatic arterial variation of the last 50 years of literature. Results Nine thousand two hundred and eighteen samples of common distribution of hepatic artery, including 2095 samples of hepatic arterial variations. Accessory hepatic artery arising from superior mesenteric artery occured in 11.18% of cases. In the next place, hepatic artery arising from left gastric artery occured in 8.54% of cases. Others variations account 3.41%. Conclusion The variations of hepatic artery are complex. Man＇s ratio of variation is evidently higher than women＇s. These types can be instruction for liver transplant, transarterial chemoembolization, surgery of stomach and pancreas.