趾足部浅淋巴管分布及其临床意义
收稿日期: 2014-09-09
网络出版日期: 2014-12-04
基金资助
徐州医学院院长专项基金（53051116）
Applied anatomy of superficial lymphatic distribution of the foot and toes
Received date: 2014-09-09
Online published: 2014-12-04
目的 探究趾和足部浅淋巴管的解剖特征，为临床提供解剖学基础。 方法 2具新鲜成人尸体的4例足部标本，在趾侧、足缘皮肤内，注入6%双氧水。在手术显微镜下解剖淋巴管，找到淋巴管插入30G细针，注入硫酸钡混合物。追踪淋巴管的行程并进行照像记录。淋巴管灌注完成后，标本进行X线摄像记录。确切显示足部浅淋巴管的解剖位置、形态、与周围静脉的关系。 结果 各趾两侧可见集合淋巴管1支，管径 0.3 mm。足背集合淋巴管由始于趾、足内外侧缘的淋巴管汇集而成，有14支,管径0.6 mm。足后区可见2支集合淋巴管，管径0.4 mm，始于内外踝与跟腱间真皮下。足部淋巴管蜿蜒地行走于皮下组织，与静脉交汇时，从其浅面和/或深面通过。 结论 本文准确地描述了足部浅表淋巴管的解剖形态，以及与周围组织、血管神经的关系，为相关的临床和科研提供了解剖学依据。
曾凡强 , 潘伟人 , 王德广 . 趾足部浅淋巴管分布及其临床意义[J]. 中国临床解剖学杂志, 2014 , 32(6) : 655 -658 . DOI: 10.13418/j.issn.1001-165x.201
Objective To determine the superficial lymphatic anatomy of the foot for clinic applications. Methods Four feet harvested from two unembalmed human cadavers were studied. Under a surgical microscope, a mixture of 6% hydrogen peroxide was used to detect lymphatic vessels commencing on bilateral sides of each toe and the foot edge. The collecting lymphatic vessel was found beneath the dermis. A 30-gauge needle was inserted and injected with a radio-opaque barium sulphate mixture. The vessels were traced, photographed and radiographed to demonstrate the lymphatic distribution and the relationship with the superficial veins of the foot. Results Each toe contained two lymph collecting vessels, one on each side. The mean vessel diameter was 0.5 mm. An average of fourteen lymph collecting vessels were found in the subcutaneous tissue of the dorsum of the foot. The mean vessel diameter was 0.6 mm. They were the continuation of lymph vessels arising from the toes, the medial and the lateral borders of the foot. There were a few vessels (mean 2, range 1 to 4) were distributed in the posterior aspect of the foot, arising from the sides of the Achilles tendon bilaterally in the subcutaneous tissue just above the heel. Lymphatic vessels of the foot travelled in a meandering fashion within the subcutaneous tissue and passed over and/or under the veins where they met. Conclusion Actual and accurate superficial lymphatic distribution of the foot has been described. This information upgrades the knowledge of the lymphatic anatomy and the results will be of bene?t for clinical management and further studies in the region.
Key words： Lymphatic vessel; Foot; ymphedema; Lymphovenous anastomosis; Lymphatic skin flap
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