人体肝脏前裂静脉的解剖学特点

Anatomical characteristics of human hepatic anterior fissure vein

  • 摘要:
    目的 探讨人体肝脏前裂静脉的解剖学特点。
    方法 采用回顾性描述性研究方法。收集2018年3月至2021年3月哈尔滨医科大学人体解剖学教研室的22具成人尸体标本;男15具,女7具;年龄为45(18~75)岁。观察指标:(1)肝脏前裂静脉识别率及汇入肝静脉位置。(2)肝脏前裂静脉长度及汇入肝静脉开口直径。(3)肝脏前裂静脉与肝Ⅷ段腹侧肝静脉(V8v)位置及V8v情况。(4)肝脏前裂静脉与前腹段门静脉及前背段门静脉的关系。正态分布的计量资料以x±s表示,组间比较采用t检验。偏态分布的计量资料以M(范围)表示,计数资料以绝对数或百分比表示。
    结果 (1)肝脏前裂静脉识别率及汇入肝静脉位置:22具尸体肝脏标本中,肝脏前裂静脉识别率为90.9%(20/22),9.1%(2/22)的尸体肝脏标本不存在肝脏前裂静脉。肝脏前裂静脉汇入肝中静脉近端和肝右静脉近端比例分别为19/20和1/20,无汇入肝中静脉远端和肝右静脉远端的标本。(2)肝脏前裂静脉长度及汇入肝静脉开口直径:20具有肝脏前裂静脉的尸体肝脏标本中,肝脏前裂静脉长度为(6.41±1.26)cm,肝脏前裂静脉汇入肝静脉开口直径为(0.38±0.10)cm。(3)肝脏前裂静脉与V8v位置及V8v情况:22具尸体肝脏标本中,25支V8v分支均汇入肝中静脉近端,V8v长度为(3.83±0.36)cm,V8v直径为(0.16±0.08)cm。17具尸体肝脏标本同时存在肝脏前裂静脉和V8v,V8v汇入肝脏前裂静脉后再汇入肝中静脉比例为14/17,肝脏前裂静脉与V8v分别汇入肝中静脉比例为3/17,无肝脏前裂静脉汇入肝右静脉且V8v汇入肝中静脉标本。(4)肝脏前裂静脉与前腹段门静脉及前背段门静脉的关系:20具有肝脏前裂静脉尸体肝脏标本中,16具肝脏标本中的肝脏前裂静脉可作为划分肝右前区前腹段和前背段的分界标识。肝脏前裂静脉与前腹段门静脉距离为(1.40±0.43)cm,与前背段门静脉距离为(1.46±0.63)cm,两者比较,差异无统计学意义(t=1.00,P>0.05)。
    结论 多数正常成人肝脏存在肝脏前裂静脉,且肝脏前裂静脉多汇入肝中静脉近端;通过V8v情况可辨别肝脏前裂静脉;肝脏前裂静脉可作为划分肝右前区前腹段与前背段的分界标识。

     

    Abstract:
    Objective To investigate the anatomical characteristics of human hepatic anterior fissure vein.
    Methods The retrospective and descriptive study was used. A total of 22 adult cadaver specimens were collected from the Department of Human Anatomy of Harbin Medical University from March 2018 to March 2021. There were 15 males and 7 females, aged 45(range, 18‒75)years. Observation indicators: (1) recognition rate of hepatic anterior fissure vein and the location of hepatic anterior fissure vein merging into hepatic vein; (2) length of hepatic anterior fissure vein and the opening diameter of hepatic anterior fissure vein merging into hepatic vein; (3) location of hepatic anterior fissure vein and the ventral hepatic vein of segment Ⅷ of liver (V8v) as well as V8v condition; (4) relationship among hepatic anterior fissure vein, anterior ventral portal vein and anterior dorsal portal vein. Measurement data with normal distribution were represented as Mean±SD, and t test was used for comparison between groups. Measurement data with skewed distribution were represented as M(range), and count data were expressed as absolute numbers or percentages.
    Results (1) Recognition rate of hepatic anterior fissure vein and the location of hepatic anterior fissure vein merging into hepatic vein. The recognition rate of hepatic anterior fissure vein of 22 liver samples was 90.9% (20/22). There were 9.1%(2/22) of liver samples without hepatic anterior fissure vein. The proportions of hepatic anterior fissure vein merging into proximal middle hepatic vein and proximal right hepatic vein were 19/20 and 1/20, respectively. There was no liver sample with hepatic anterior fissure vein merging into distal middle hepatic vein and distal right hepatic vein. (2) Length of hepatic anterior fissure vein and the opening diameter of hepatic anterior fissure vein merging into hepatic vein. In the 20 liver samples with hepatic anterior fissure vein, the length of hepatic anterior fissure vein was (6.41±1.26)cm, and the opening diameter of hepatic anterior fissure vein merging into hepatic vein was (0.38±0.10)cm. (3) Location of anterior fissure vein and the V8v and V8v condition. In the 22 liver samples, there were 25 V8v branches merging into the proximal middle hepatic vein, with the V8v length as (3.83±0.36)cm and the V8v diameter as (0.16±0.08)cm. In the 17 liver samples with both hepatic anterior fissure vein and V8v, the proportion of V8v merging into hepatic anterior fissure vein and then into middle hepatic vein was 14/17, the proportion of hepatic anterior fissure vein and V8v merging into middle hepatic vein separately was 3/17, and there was no liver sample with hepatic anterior fissure vein merging into right hepatic vein and V8v merging into middle hepatic vein. (4) Relationship among hepatic anterior fissure vein, anterior ventral portal vein and anterior dorsal portal vein. Of the 20 liver samples with hepatic anterior fissure vein, the hepatic anterior fissure vein of 16 liver samples could be used as the demarcation mark of anterior ventral segment and anterior dorsal segment of hepatic right anterior region. The distance between the hepatic anterior fissure vein and anterior ventral portal vein was (1.40±0.43)cm, and that between the hepatic anterior fissure vein and anterior dorsal portal vein was (1.46±0.63)cm, showing no significant difference between them (t=1.00, P>0.05).
    Conclusion The hepatic anterior fissure vein exists in most normal adult livers, and it mostly merges into proximal middle hepatic vein. The hepatic anterior fissure vein can be identified by the condition of V8v. The hepatic anterior fissure vein can be used as the demarcation mark of anterior ventral segment and anterior dorsal segment of hepatic right anterior region.

     

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