大肠癌肝内转移灶分布研究

Study of the pattern of distribution of large intestinal carcinoma metastases to the liver

目的为了探讨门静脉内是否存在血液流线型分流以及这种分流是否影响大肠癌转移灶在肝内的分布，为防治方法及途径提供依据。方法根据肠系膜上、下动脉供血范围不同。以脾曲为界，将整个大肠分为左右两半，分别观察各半结肠癌在肝内左右两叶转移灶的分布情况。结果和结论肠系膜上、下静脉及脾静脉在汇入门静脉后，其血液并未完全混合，存在流线型血液分流，且对肝内转移灶的分布造成影响。右半结肠癌者的肝内转移灶多分布在肝右叶，左半结肠癌者肝内转移灶则呈随机分布。对右半结肠癌患者，位于肝右叶的转移灶有较强的手术指征。除经肝动脉化疗外，经门静脉系统化疗可能更为合理。

Objective To see whether there is a streamline blood flow in the portal vein and whether it is related to with the distributional pattern of the metastatic foci in the liver and to find a relatively reasonable approach to the intrahepatic metastasis, we have done the clinical research work on this field. Methods Based on the ranges of blood suply of the supperior and inferior mesenteric arteries, the large intestine was arbitrarily divided into two parts at the splenic flexure. All metastatic foci in the liver were studied according to their different origins. Results and Conclusion After the blood from the superior and inferior mesenteric veins and splenic vein entering the portal vein, they were not well mixed. The right-sided colon cancers mainly involved the right hepatic lobe, while the left-side ones involved the two hepatic lobes randomly. There are stronger indications for the patients with right-side colon cancer to have their matastased right hepatic lobe metastastic foci resected. As to the route of chemotherapy, it would be more reasonable to choose by may of chemotherapy via the portal vein Liver.