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[脾动脉的解剖结构]

[Anatomy of the splenic artery].

作者信息

Jáuregui E

机构信息

2a Cátedra de Anatomía Normal, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 1999;56(1):21-41.

Abstract

Due to the importance and permanent improvements as regards the treatment of different diseases involving abdominal organs such as the abdomen, pancreas and spleen. I was indined to investigate, both from the anatomic and surgical point of view, one of the collateral arterial branches of the celiac trunk, which is possibly considered to be one the least studied and, historically one of the most forgotten by the vessels irrigating the liver and stomach. Considering the fact that anatomic understanding is the starting point of medical knowledge, and that its conquests give it permanently new fundaments, I was determined to do research, intensely and thoroughly on splenic artery. This research work relates in detail, on the corresponding chapters, the material and methods used, which consist on human bodies and foetus fixed with formol and in a fresh condition. These human bodies and foetus were submitted to dissection techniques of inter-arterial injection with resin, and then they were corroded with acid and angiographic studies. Finally selective arteriographic tests were performed on living beings by means of digitalis removal of the splenic artery. The following chapter deals with the results obtained from saied research work, showing that the splenic artery originates, in all cases, from the celiac trunk, and this artery is the most important with an average length of 10.6 centimeters and of 2.3 flexuosities in all. This chapter also enumerates the relationships existing between the splenic artery and neighboring organs, the homonymous vein, its collateral and terminal branches which in the hundred percent of cases showed one superior and one inferior, to immediately subdivide in different ones at the level of the splenic pedide. The collateral branches found were the following: arterial pancreatic branches found in the 73% of the cases with an average of 1.8 arteries in all. posterior esophaguscardiotuberosity artery appearing in a 33% of the cases. superior polar artery appearing in a 53% of the cases. inferior polar artery appearing in a 33% of the cases. the short vessels appeared in the 100% of the cases, from which in a 73% were superior short vessels and in the remaining 27% inferior short vessels. the left gastroepiploon artery appeared in all the cases considered. I have discussed the anatomic importance of the splenic artery and gland with their multiple variations and relationships. I have also considered the splenic pedicle, depending on the rear fixation which has the extremity of the pancreas and the splenic hillum of 2.2 centimeters, with final figures ranging from 0 to 4 centimeters. I have also mentioned the appearance of a 10% of super numerary spleens. Finally in our experience with splenic segmentation and with corrosion pharmaceutical preparation and arteriographic studies as the basic ingredients, we have found that in a 62.5% they have two segments, in a 17% they have three segments, in a 12.5% they have four segments, in a 12.5% they have four segments and in an 8% they have five segments in all, in these cases generally due to the high importance of the polar arteries. Likewise, it is a truth universally accepted that splenic circulation is terminal and that spleen division into segments is separated by non-vascular levels.

摘要

鉴于涉及腹部器官(如腹部、胰腺和脾脏)的不同疾病治疗方面的重要性和持续进展,我倾向于从解剖学和手术学角度研究腹腔干的一个分支动脉,它可能被认为是研究最少的,并且在历史上是肝脏和胃供血血管中最容易被遗忘的之一。考虑到解剖学理解是医学知识的起点,并且其成果为医学提供了永久的新基础,我决定对脾动脉进行深入而全面的研究。这项研究工作在相应章节中详细阐述了所使用的材料和方法,包括用福尔马林固定的人体和新鲜胎儿。这些人体和胎儿接受了动脉间树脂注射的解剖技术,然后用酸腐蚀并进行血管造影研究。最后,通过去除脾脏动脉的洋地黄制剂对活体进行选择性动脉造影测试。接下来的章节阐述了上述研究工作的结果,表明在所有情况下脾动脉均起源于腹腔干,该动脉最为重要,平均长度为10.6厘米,共有2.3个弯曲。本章还列举了脾动脉与相邻器官、同名静脉、其分支和终末分支之间的关系,在所有病例中,这些分支均显示出一支上支和一支下支,在脾蒂水平立即再细分为不同分支。发现的分支如下:73%的病例中发现动脉胰腺分支,平均共有1.8条动脉;33%的病例中出现食管后心结节动脉;53%的病例中出现上极动脉;33%的病例中出现下极动脉;100%的病例中出现短血管,其中73%为上短血管,其余27%为下短血管;所有考虑的病例中均出现胃网膜左动脉。我讨论了脾动脉和脾脏的解剖学重要性及其多种变异和关系。我还考虑了脾蒂,取决于胰腺末端和脾门的后方固定,长度为2.2厘米,最终数值范围为0至4厘米。我还提到了10%的额外脾脏的出现。最后,根据我们对脾脏分段以及以腐蚀药物制剂和动脉造影研究为基本要素的经验,我们发现62.5%的脾脏有两段,17%有三段,12.5%有四段,12.5%有四段,8%有五段,在这些情况下通常是由于极动脉的高度重要性。同样,脾循环是终末循环且脾段之间由无血管平面分隔这一事实是普遍公认的。

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