活体胃血供的特点及其临床意义

The characteristic and clinical significance of stomach blood supply in patients with gastric ulcer

目的 了解活体胃血供的特点 ,旨在探索中晚期胃癌的局部灌注化疗方法。方法 对 36例胃溃疡患者在行胃大部切除治疗时 ,进行亚甲蓝染色 ,观察活体胃各分支动脉自然血供区域和血流阻断后血供范围的变化。结果 术中见左、右胃网膜动脉和左、右胃动脉分别为胃大、小弯近、远段相应区域提供血液 ,胃壁组织染色时间很短 ;阻断动脉血流后 ,染色范围扩展 ,染色时间延长 ;阻断伴行静脉后 ,染色范围进一步扩展 ,染色时间再度延长。结论 胃左动脉和胃网膜右动脉为胃血供的主要动脉 ,其他动脉分支为辅助性动脉 ;一般情况下 ,经动脉灌注的亚甲蓝在胃组织停留时间极短 ;阻断伴行静脉后 ,可使该染料在组织停留时间延长。推测此法可使化疗药物在胃组织中存留时间延长 。

Objective To observe the characteristic of stomach blood supply in patients to explore the perfusional method of chemotheray in patients with advanced gastric carcinoma. Methods The changes of gastric blood supply in 36 patients with gastric ulcer was oberserved by means of methylene blue dye before and after the blood supply was occluded. Results The blood supply of the distal and proximal partion of great and minor gastric curvature were came from right and left gastro-epiploic artery and right and left gastric artery,respectively,seeing in operation, and the dyed time of gastric tissue was short. The dyed region and time were extended when the arteries were blocked. The dyed region and time were further extended after the acompany veins were blocked. Conclusions The left gastric artery and right gastric-epiploic artery are the main arteral supply of the stomach, the others are supplementary. In general conditions , methylene blue injected through the artery stays shortly in gastric tissue. After the arteries were blocked, methylene blue stays longer in gastric tissue;meanwhile blocked the acompany veins of the arteries can increase the staying time of chemotherapeutic drugs in gastric tissue and thus can help improve local chemotherapic effect of gastric carcinoma.