脾内动脉吻合的临床意义初探

A Preliminary Study of Clinical Significance of Intrasplenic Arterial Anastomoses

目的:探讨脾内动脉吻合与部分脾栓塞术(PSE) 及部分脾切除术的关系。材料与方法:回顾性分析110 例脾动脉造影病例,着重观察脾内动脉吻合的出现率、吻合形式、部位及吻合点远端脾动脉分支直径。结果:脾内动脉吻合的显示率为22-7 % ,其中叶间吻合10 % 、段间吻合7-3 % 。吻合形式分为短交通支吻合、弓形吻合、汇集型吻合三种。吻合点远端脾动脉分支直径≤1m m 者占5-5 % 。结论:若采用1m m3( 或以下) 容积的栓塞剂行PSE 术,栓塞剂绝大部分滞留在吻合点远端的脾动脉分支内,吻合动脉不能向被栓塞的脾实质供血。但行部分性脾切除术时,应警惕叶间、段间吻合动脉的出现并慎重处理这些吻合动脉。

Purpose:To investigate the related clinical implications of intrasplenic arterial anastomoses.Material and Methods:The visualization rates、forms and sites of intrasplenic arterial anastomoses and the diameters of distal splenic artery branches of anastomosis points were studied retrospectively in 110 splenic arteriographic films.Results:The visualization rates of intrasplenic arterial anastomoses were 22.7%,in which the anastomoses between lobes,segments were 10%and 7.3% respectively.The forms of anastomoses were divided into 3 types:the anastomoses of short communications,arch anastomoses and the anastomoses of collecting shape.The diameters of distal splenic arteries of anastomosis pionts were less than 1mm in 5.5% cases.Conclusion:When 1mm 3(or less than 1mm 3)gelfoam paticles are used in embolizing splenic arteries,few of them will be held up in proximal splenic arteries of anastomosis pionts.anastomotic arteries can't supply blood for embolized splenic parenchyma.But,when reguar partial splenectomy is performed,anastomotic arteries should be carefully handled.