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根据小肠代食管手术设计的要求,解剖并测量了50例成年尸体的小肠血管、胸廓内血管和甲状腺上动脉。 1.小肠动脉小肠动脉的支数平均为5.4支。小肠动脉的管径为1.5～10.0毫米,3毫米以上的占半数以上。第1～6小肠动脉的平均长度为25～45毫米,30毫米以上的占半数以上。其中以第3小肠动脉最长(45毫米),管径也较大(4.0毫米),是较为理想的吻接动脉。小肠动脉有22％出现短干。短干的分支中,都有1～2支较长且粗,手术中可当作一个小肠动脉加以利用。小肠动脉弓的级数平均2.7级。第1、2级动脉弓的管径都较粗大;第3级弓以下的管径在0.9毫米以下的较多。故手术中展直小肠时,以保留第二级弓为宜。 2.小肠的长度空回肠的总长度为531厘米(328～765)。小肠动脉所分布的肠管长度,由第1小肠动脉至第8小肠动脉是逐渐增加的(37～253厘米)。在空肠上段,保留有代偿能力的、管径在1.0毫米以上的动脉弓,剪断肠系膜,展直肠袢,每展直1厘米,所对应的肠管为2.6厘米。 3.小肠静脉平均支数为2.9支(1～5),比动脉少。一个小肠静脉往往与两个以上的动脉相对应,它的第1级属支基本上与动脉伴行。 4.甲状腺上动脉在动脉分支前测量了管径,左侧为3.1毫米,右侧为2.8毫米。甲状腺上动脉是受区较为理想的一个吻接动脉。 5.胸廓内血管胸廓内动脉在第二、三肋间的管径平均为2.6～2.8毫米。静脉的管径平均为2.4～3.1毫米。胸廓内动脉的管径与小肠动脉很接近,但静脉的管径显得细小。因此,胸廓内动脉是小肠代食管手术中的理想备用吻接动脉。但受区的静脉则以选用管径较粗的颈外静脉或颈前静脉为宜。
According to the design of small intestine on behalf of esophageal surgery, anatomy and measurement of 50 adult cadaveric small intestine blood vessels, thoracic blood vessels and thyroid artery. 1. The small intestine artery intestine artery count an average of 5.4. Small intestine artery diameter of 1.5 to 10.0 mm, 3 mm above account for more than half. The first ~ 6 small intestine artery average length of 25 ~ 45 mm, 30 mm above accounted for more than half. Among them, the longest diameter of the third small intestine (45 mm), larger diameter (4.0 mm), is the ideal kissing artery. 22% of small intestine arteries appear dry. Short branch, there are 1 to 2 long and thick, surgery can be used as an intestinal artery. Intestinal artery bow series average 2.7. Grade 1 and 2 arterial arch diameter are more coarser; level 3 below the bow below 0.9 mm in diameter. Therefore, when surgery to straighten the small intestine, to retain the second stage bow is appropriate. 2. Length of the intestine The total length of the ileum is 531 cm (328 to 765). Intestinal artery distribution of intestinal length, from the first small intestine artery to the small intestine artery is gradually increased (37 ~ 253 cm). In the upper jejunum, an compensatory arterial arch with a diameter of 1.0 mm or more is retained, the mesentery is cut, and the rectum is straightened up to 1 cm. The corresponding bowel is 2.6 cm. 3. The average number of small intestine veins 2.9 (1 ~ 5), less than the arteries. One small intestine vein often corresponds to more than two arteries, and its first level branch is basically associated with the arteries. 4. Thyroid artery in the arteries before the branch was measured diameter, left 3.1 mm, right 2.8 mm. Thyroid artery is the ideal area by a kissing artery. 5. Thoracic vascular thoracic artery in the second and third intercostal diameter average 2.6 to 2.8 mm. The average diameter of the vein is 2.4 ~ 3.1 mm. The diameter of the internal thoracic artery is very close to that of the small intestine, but the diameter of the vein is small. Therefore, the internal thoracic artery is ideal for small bowel esophageal anastomosis in the arteries. However, the area of the vein is to use the diameter of the jugular vein or anterior cervical vein is appropriate.