选择性动脉造影在干细胞移植治疗糖尿病中的临床意义

目的观察胰背、胰横及胰前弓动脉的血管造影解剖,评价其在干细胞移植治疗糖尿病中的应用价值。方法对108例糖尿病干细胞移植患者的造影图片进行回顾性分析,观察胰背、胰横动脉的血管造影解剖。结果①胰背动脉出现率为86.11%(93/108),起自脾动脉占69.89%(65/93),起自肠系膜上动脉占8.6%(8/93),起自肝总动脉占10.75%(10/93),起自胃十二指肠动脉占4.3%(4/93),起自腹腔动脉占6.45%(6/93)。②胰横动脉出现率87.96%(95/108),起自胰背动脉左支的占84.21%(80/95),起自胰大动脉占8.42%(8/95),胰前弓动脉直接延续为胰横动脉占7.37%(7/95)。③胰前弓动脉出现率85.19%(92/108),起自胰十二指肠上前动脉占79.35%(73/92)、起自胃十二指肠动脉占15.22%(14/92),起自胃网膜右动脉者占5.43%(5/92)。④胰背动脉插管失败者12例(胰前弓动脉显影),采用胰前弓动脉超选择插管使手术成功11例。结论①胰背、胰横动脉及胰前弓动脉出现率极高,但起始位置不固定;②对于胰背动脉插管困难的患者尝试采用超选择胰前弓动脉插管可大大提高手术成功率。

Objective To observe the dorsal、transverse pancreatic and anterior pancreatic areade artery angiography anatomy,evaluate the application value in stem cell transplantation for the treatment of diabetes mellitus.Methods One hundred and eight patients with diabetes mellitus stem cell transplantation in patients with angiographic images were analyzed retrospectively,dorsal and transverse pancreatic artery angiography anatomy were observated.Results ①Dorsal pancreatic artery occurrence rate was 86.11%（93/108） ,starting from the splenic artery accounted for 69.89%（65/93） ,starting from the superior mesenteric artery 8.6%（8/93） ,starting from the common hepatic artery accounted for 10.75%（10/93） ,starting from the gastroduodenal artery accounted for 4.3%（4/93） ,starting from the celiac artery 6.45%（6/93） .②Transverse pancreatic artery occurrence rate was 87.96%（95/108） ,from the left branch of dorsal pancreatic artery accounted for 84.21%（80/95） ,starting from the greater pancreatic artery accounted for 8.42%（8/95） ,anterior pancreatic areade artery direct continuation for transverse pancreatic artery accounted for 7.37%（7/95） .③Anterior pancreatic areade artery occurrence rate was 85.19%（92/108） ,starting from the anterior superior pancreaticoduodenal artery accounted for 79.35%（73/92） ,starting from the gastroduodenal artery accounted for 15.22%（14/92） ,starting from the right gastroepiploic artery accounted for 5.43%（5/92） .④Dorsal pancreatic artery intubation failure in 12 cases,using anterior pancreatic areade artery superselective catheterization of the operation was successful in 11 cases.Conclusion ①Dorsal,transverse pancreatic artery and anterior pancreatic areade artery have a high rate of emergence,but the starting position is not fixed;②using superselective anterior pancreatic areade artery cannulation can greatly improve the success rate for the patients which not success for conventional intubation.