肝动脉解剖变异及其临床意义
The anatomic variations of hepatic artery and its clinical correlation
目的 解剖肝动脉，分析其变异规律，以期为临床提供形态学基础。 方法 随机选取74具尸体，充分解剖暴露腹腔动脉及其分支，对肝动脉的起源、行径进行仔细观察和记录。 结果 本研究观察到Hiatt六种分型中的三种： Ⅰ型正常型占77.02%（57例）：肝总动脉起于腹腔干，分为胃十二指肠动脉和肝固有动脉，后者又分为肝左、中、右动脉；Ⅱ型占9.47%(7例)：替代性或副的肝左动脉起于胃左动脉；Ⅴ型占1.35%(1例)：肝总动脉起于肠系膜上动脉。除此之外，还观察到三种罕见的类型：Ⅶ型占6.76%(5例)：替代性肝左动脉起于肝总动脉；Ⅷ型占2.70%(2例)：替代性肝右动脉起于胃十二指肠动脉；Ⅸ型占2.70%(2例)：替代性肝左动脉与胃及食管的动脉分支共干，在本研究中，称其为共干动脉,起于腹腔动脉。 结论 本研究在小样本中观察到3种罕见的变异类型，提示肝动脉变异具有极大的复杂性和偶然性。临床医生对此应予以高度重视。
Objective To summarize the variations of the hepatic artery, and provide anatomic basis for clinic application. Methods A total of 74 cadavers were collected randomly for his study. The celiac artery and its branches were completely exposed. The hepatic artery were observed and recorded. Results Referring to Hiatt's six types of hepatic artery，three of them were observed: Type I(n=57, 77.02%),with the common hepatic artery originating from the celiac artery to form the gastroduodenal and proper hepatic arteries，and the proper artery dividing distally into right, middle and left branches; Type II (n=7, 9.47%), with a replaced or accessory left hepatic artery originating from left gastric artery; Type V (n=1, 1.35%), with the common hepatic artery originating directly from superior mesenteric artery. Besides, three uncommon types were found: Type VII (n=5, 6.76%), with a replaced left hepatic artery originating from common hepatic artery; Type VIII (n=2, 2.70%),with a replaced right hepatic artery originating from gastroduodenal artery; Type IX (n=2, 2.70%), with a replaced left hepatic artery together with the gastric and esophageal branches originating directly from celiac artery. Conclusions Three uncommon variant types of hepatic artery are observed in our small samples, which indicates that, the variation of the hepatic artery is complex and occasional, which should be pay close attention to this features.
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