解剖学分类和临床意义的右中叶叶静脉对流变异在右上叶切除术:一个三维重建研究研究
Tian Hao1,2, Lei Xu3, Si-Ming Jiang4
1Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Clinical and experimental pharmacology & physiology
|July 22, 2025
概括
右中叶 (RML) 静脉的解剖学变异在手术期间存在风险. 对于RML静脉解剖学的新HAO分类系统识别了高风险变异,改善了手术规划和患者安全.
科学领域:
- 胸部外科手术 胸部外科手术
- 医学成像医学成像
- 解剖学上的变化.
背景情况:
- 右中叶 (RML) 静脉变异在右上叶切除术 (RUL) 期间存在手术风险.
- 在水平裂中未被识别的静脉可能导致损伤和损害静脉排水.
- 在此之前,还没有对RML静脉交汇的全面分类.
研究的目的:
- 开发和验证RML静脉解剖学的分类系统.
- 评估影响RUL手术的RML静脉变异的流行率.
- 改善手术规划,减少RUL手术中的并发症.
主要方法:
- 对2007年接受肺部手术的患者 (2017-2023) 的回顾性分析.
- 术前基于CT的3D-CT支气管和血管学 (3D-CTBA) 用于静脉分类.
- 两个胸部外科医生根据排水模式 (H型,A型,O型) 独立地对RML静脉进行了分类 (V4a,V4b,V5a,V5b).
主要成果:
- 31.83%的患者表现出临床关键的H型变异 (流入水平裂).
- V4a*是穿过裂的最常见变体 (29.07%).
- 罕见地观察到下肺静脉 (2.59%) 或左心室 (0.20%) 的排水;手术内验证证实了分类的准确性.
结论:
- 建立了RML静脉解剖学的新型HAO分类系统.
- H型变异的高患病率 (31.83%) 需要量身定制的手术策略.
- 使用此框架的手术前3D-CTBA通过降低静脉损伤风险来提高RUL安全性.
相关概念视频
01:19Veins of Thorax
1.2K
The azygos system is a crucial part of the body's circulatory system and drains most of the thorax. It comprises the azygos, hemiazygos, and accessory hemiazygos veins.
The azygos vein, positioned just right of the midline and anterior to the vertebral column, begins at the junction of the right ascending lumbar and subcostal veins, terminating in the superior vena cava. This vein drains blood from the right side of the thoracic wall, thoracic viscera, and posterior abdominal wall.
The...
The azygos vein, positioned just right of the midline and anterior to the vertebral column, begins at the junction of the right ascending lumbar and subcostal veins, terminating in the superior vena cava. This vein drains blood from the right side of the thoracic wall, thoracic viscera, and posterior abdominal wall.
The...
1.2K
01:11Overview of Systemic Veins
717
Systemic veins are crucial blood vessels that return deoxygenated blood from various body tissues back to the heart. There are three systemic veins that return deoxygenated blood to the heart, they are as follows.
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
717