颈内静脉的静脉丛引流模式及影响因素

Analysis of internal jugular venous plexus drainage pattern and its influencing factors

目的探讨颈内静脉的主要静脉丛引流模式以及相关因素。方法根据160例脑血管病患者DSA图像资料,分析动脉造影的静脉期成像。将颈内静脉的主要静脉丛分为前路引流模式(翼静脉丛)及后路引流模式,后路引流模式分为丛状引流(椎旁静脉丛)和孤立静脉引流(以颈深部静脉为主)。后路丛状引流再分为2组:椎旁静脉丛伴或不伴明显颈深部静脉引流。根据临床资料及相关危险疾病,应用卡方检验分析颈内静脉主要静脉丛引流模式的影响因素。结果双侧颈内动脉造影显示160例病人共320侧颈内静脉,其中19.7%(63侧)为翼静脉丛引流,16.9%(54侧)为椎旁静脉丛伴有明显颈深部静脉引流,15.6%(50侧)为椎旁静脉丛伴无明显颈深部静脉引流,10侧(3.1%)为颈深部静脉引流,5.7%(13侧)为前、后丛联合引流。χ^(2)检验发现,年龄、伴颈内静脉异常(发育不全、狭窄、闭塞)、伴颈内静脉压迹、合并高血压病是影响颈内静脉静脉丛引流模式的独立危险因素。结论颈内静脉的静脉丛引流模式,以后路椎旁静脉丛引流为主,引流模式可因相关因素而改变,这对评估颅底、颈部手术及神经介入治疗具有重要价值。

Objective To explore the drainage patterns of main venous plexus in internal jugular vein and the related influencing factors.Methods According to the DSA image data of 160 patients with cerebrovascular disease,the venous imaging of arteriography was analyzed.The main venous plexus of internal jugular vein was divided into anterior drainage mode(pterygoid plexus)and posterior drainage mode,and the posterior drainage mode was divided into plexus drainage mode(paravertebral venous plexus)and isolated venous drainage mode(dominated by deep jugular vein).The posterior plexus drainage mode could be subdivided into two groups:paravertebral venous plexus with obvious deep jugular venous drainage and paravertebral venous plexus without obvious deep jugular venous drainage.Based on the clinical data of the patients and related risk diseases,the factors affecting the drainage pattern of main venous plexus of internal jugular vein were analyzed by chi-square test.Results Bilateral internal carotid artery angiography showed a total of 320 internal jugular veins in 160 patients,of which 63 sides(accounting for 19.7%)as the wing plexus drainage,54 sides(accounting for 16.9%)as the vertebral venous plexus near accompanied by obvious neck deep venous drainage,50 sides(accounting for 15.6%)as the vertebral venous plexus with no apparent near the neck deep venous drainage,10 sides(accounting for 3.1%)as the neck deep venous drainage,13 sides(accounting for 5.7%)before and after the plexus drainage.The analysis ofχ2 test showed that age,abnormal internal jugular vein(hypoplasia,stenosis,occlusion),pressure trace of internal jugular vein and hypertension were independent risk factors for the pattern of internal jugular venous plexus drainage.Conclusions The drainage pattern of bilateral internal jugular vein plexus is mainly followed by posterior paravertebral venous plexus drainage,which can change the drainage pattern with relevant clinical influencing factors.This is of great value for the evaluation of skull base,neck surgery and nerve interventional therapy.