主肝静脉和肝短静脉的解剖学研究及其临床意义

目的:探讨主肝静脉和肝短静脉（SHVs）的数量、位置、分型、口径等参数。方法:取60具成人尸体标本, 测量肝左、中、右静脉的肝外长度、注入下腔静脉（IVC）管径;按其SHVs汇入下腔静脉左侧壁、前壁和右侧壁分为左、中、右3排，测量SHVs的数量、位置、口径及其与主肝静脉的关系。结果:肝左、中、右静脉开口于IVC肝后段上l/4段，其中肝左、中静脉共干者73.3%（44例），肝左、中、右静脉共开口者1.7%（1例），3支分别汇入者25.0%（15例），SHVs直径为1.5～17.8（5.4±1.4）mm,3～35支SHV从不同方向和节段注入下腔静脉。肝右静脉直径与SHVs直径呈负相关（r=-0.34，P＜0.05);肝左静脉直径与SHVs数目呈负相关（r=0.24， P＜0.05)。肝右后下静脉（IRHV）出现率为83.3%，平均直径为2.6～8.0（4.3±1.2）mm。结论:SHVs变异较大，管径粗者数量少。SHVs的口径、数目与主肝静脉口径、数目呈相互消长。肝右静脉直径愈大，SHVs直径愈小;反之SHVs直径愈大。肝左静脉直径愈大，SHVs数量愈少;反之SHVs数量愈多。

An anatomical study on the major and short hepatic veins

Abstract:Objective:To observe the number，location,type and caliber of the major hepatic veins and short hepatic veins（SHVs）. Methods:The SHVs were divided into 3 rows that drained into the left wall, front wall and right wall of the inferior vena cava (IVC) respectively.The extrahepatic length and caliber of the major hepatic veins, the number,location, caliber and the relationship between the major hepatic veins and SHVs were observed and measured in 60 adult cadavers.Results:The left, middle and right hepatic veins drained into the upper 1/4 segment of the retrohepatic IVC. The left and middle hepatic veins formed a common trunk in 44 cases (73.3%), the 3 major hepatic veins formed a common trunk in 1 case (1.7%), and the 3 major hepatic veins had separate inflow into IVC in 15 cases (25.0%). Three to thirty five branches of SHVs with a mean diameter of 1.5～17.8（5.4±1.4）mm had inflow into the IVC from different directions and locations.There was marked negative correlation between the diameter of the right hepatic vein and that of SHVs.There has marked negative correlation between the diameter of the left hepatic vein and the right hepatic vein with the number of SHVs.The incidence rate of inferior right hepatic veins was 83.3% with an average diameter of 2.6～8.0（4.3±1.2）mm.Conclusions:The SHVs have much variations but few of them are of large diameter. The diameter and number of SHVs and those of the major hepatic veins are correlated, so that the larger the diameter of the right or left hepatic veins the smaller is the diameter of the SHVs, and vice-versa.