小隐静脉旁淋巴管的应用解剖
Applied anatomy of the lymphatic vessels alongside the small saphenous vein
目的 研究小隐静脉旁淋巴管的解剖特征，为临床应用提供解剖学基础。 方法 成人新鲜尸体3具，截取3对下肢。外踝后皮内注入少量双氧水，真皮下找到淋巴管，将显影剂经30G注射针注入，使其显影，追踪并显示小隐静脉旁淋巴管的走行，同时进行拍照及X线摄像，依次到达小腿及腘窝。 结果 小隐静脉旁均可见内侧支和外侧支集合淋巴管，有的始于外踝后区真皮下，有的始于小腿后下部。淋巴管沿小隐静脉两侧蜿蜒曲折向心性走行，管间有分支相连接。近腘窝时，淋巴管与小隐静脉一起穿过深筋膜进入腘窝，然后发出多个小分支汇入淋巴结。此组淋巴管管径在0.3~1.5 mm之间，近侧较粗，远侧稍细。 结论 精确描述了下肢小隐静脉旁淋巴管的分布与走行，为临床应用提供重要的解剖学参考。
Objective To determine the lymphatic anatomy around the small saphenous vein (SSV). Methods Six legs harvested from three unembalmed human cadavers were studied. Under a surgical microscope, a mixture of 6% hydrogen peroxide was used to detect the lymphatic vessels commencing in the skin between the lateral malleolus and the Achilles tendon. A 30-gauge needle was inserted into the lymphatic vessel and injected with a radio-opaque barium sulphate or lead oxide mixture. The vessels around SSV were traced, photographed and radiographed. Results Two collecting lymphatic vessels were found along SSV, one on each side. They originated beneath the dermis between the lateral malleolus and the Achilles tendon and some of them from the posteroinferior part of the leg. The vessels travelled tortuously in the subcutaneous tissue on each side of SSV and pierced the deep fascia in the posterosuperior part of the leg to enter the popliteal fossa. They then divided into small branches before entering the popliteal lymph nodes. The diameters of the vessels varied from 0.3 to 1.5 mm, larger in the proximal side and smaller in the distal end. Conclusion Actual and accurate lymphatic anatomy of the human extrimities has been described. This information can improve our anatomical knowledge and the results will be of bene?t for clinical management and further studies in the region.
淋巴管 / 小隐静脉 / 淋巴水肿 / 淋巴管静脉吻合 / 淋巴管移植
Lymphatic vessel / Small saphenous vein / Lymphedema / Lymphaticovenular anastomosis / Lymphatic grafting
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徐州医学院院长专项基金（53051116）； 徐州医学院课题（2012KJ11)
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