肝后下腔静脉前间隙的临床解剖学研究

Clinical Anatomical Study of the Retro-Hepatic Tunnel

目的:探讨肝后下腔静脉前间隙的解剖基础及其临床应用价值。方法:在安徽医科大学解剖教研室选取的甲醛溶液固定的成人肝脏19例,标本的腔静脉系统用乳胶灌注。以尾状叶静脉与肝中静脉右缘的连线为下腔静脉前间隙的左侧界线;以肝右后下静脉与肝右静脉左缘的连线为下腔静脉的右侧边界。打开下腔静脉,数显卡尺测量下腔静脉前间隙内的直径超过1mm肝短静脉。结果:下腔静脉前间隙的左、右边界分别为尾状叶静脉与肝中静脉右缘的连线,肝右后下静脉与肝右静脉左缘的连线;19例标本中14例出现肝右后下静脉、肝右后中静脉或二者同时存在,在所有的标本中都存在Spiegel叶静脉;在下腔静脉前间隙内,有少量细小的肝短静脉。结论:肝后下腔静脉前间隙有其解剖学基础,在肝脏外科中具有重要的意义。

Objective： To study the existence and clinical value of the tunnel between the retro-hepar and anterior surface of the retrohepatic portion of IVC.Methods： The experiment was conducted in the Research Institute of Clinical Anatomy,Anhui Medical University.Totally 19 formalin fixed adult livers were selected.Caval venous system of specimen was perfused with emulsion.Left borderline of space before I VC was the line between caudate vein and right edge of middle hepatic vein;Right borderline of IVC was the line between inferior right hepatic vein （IRHV） and left edge of right hepatic vein.Inferior caval vein was opened.Short hepatic vein over 1 mm was measured in space before IVC with digital display caliperru.Results： Left and right borderline of the space before IVC was the line between caudate vein and right edge of middle hepatic vein and the line between IRHV and left edge of right hepatic vein,respectively.Totally 14 cases of 19 livers had IRHV,MRHV or both.Spiegel lobe vein existed in all specimens.Few thin short hepatic vein appeared in the space before IVC.Conclusions： The retrohepatic tunnel exactly exists and it is of great value in the difficult hepatectomy,caudate lobectomy and the liver dissecting in piggyback live transplantation.