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目的采用数字减影血管造影(DSA)方法,研究糖尿病患者胰体尾优势供血动脉的解剖特点,为临床胰腺介入治疗提供血管解剖依据。方法糖尿病患者108例,男61例,女47例,于介入治疗手术室行胰体尾动脉造影。第一阶段进行腹腔干、胃十二指肠动脉、肠系膜上动脉造影,初步定位胰尾体部优势供血动脉,之后将导管直接置入目标动脉,行DSA,观察胰体尾显影情况。如置入失败,则采用脾动脉远端球囊堵塞近端造影的方法,对胰体尾进行显影。保存介入影像进行分析。结果造影显示,胰体尾优势供血动脉分别为胰背动脉(58.3%,63/108)、胰大动脉(13.9%,15/108)、胰背动脉联合胰大动脉(11.1%,12/108)、胰横动脉(14.8%,16/108)和其他(1.9%,2/108)。优势动脉当中胰背动脉(共75例,胰背动脉单独63例,胰背联合胰大动脉12例)主要起源于脾动脉起始段(52.0%,39/75)、肝总动脉(21.3%,16/75)和肠系膜上动脉(24.0%,18/75)等;胰大动脉(共27例,胰背联合胰大动脉12例,胰大动脉单独15例)主要起源于脾动脉中段(96.3%,26/27);而胰横动脉主要起源于胃十二指肠动脉(68.8%,11/16)和胰十二指肠动脉(31.2%,5/16)等。结论胰体尾优势供血动脉的分布与起源存在较多变异情况,研究胰体尾部优势供血动脉有助于糖尿病患者胰腺介入治疗。
Objective To study the anatomical characteristics of the superior artery of pancreas and tail artery in diabetic patients by digital subtraction angiography (DSA), and to provide anatomical basis for the clinical interventional therapy of pancreas. Methods A total of 108 patients with diabetes mellitus, 61 males and 47 females, were involved in the operation room for pancreatic tail artery angiography. The first phase of celiac, gastroduodenal artery, superior mesenteric artery angiography, the initial positioning of the tail part of the tail artery supply artery, and then the catheter directly into the target artery, line DSA, observation of pancreatic body tail development. If the placement fails, then use the method of proximal balloon occlusion of the splenic artery to develop the body and tail of the pancreas. Save the interventional image for analysis. The results of angiography showed that the predominant pancreatic body and tail blood donors were pancreatic dorsal artery (58.3%, 63/108), pancreatic artery (13.9%, 15/108), pancreatic dorsal artery (11.1%, 12/108) Transverse pancreatic artery (14.8%, 16/108) and others (1.9%, 2/108). Among the predominant arteries, there were 75 cases of pancreatic dorsal artery (total of 75 cases, 63 cases of pancreatic dorsal artery alone and 12 cases of pancreatic dorsal pancreas). The main origins were the initial section of the splenic artery (52.0%, 39/75), common hepatic artery (21.3% (27 cases, pancreaticoduodenal artery in 12 cases, pancreatic artery in 15 cases) mainly originated in the middle of the splenic artery (96.3%, 26/75) and the superior mesenteric artery (24.0%, 18/75) / 27). The transverse pancreatic artery originated mainly from gastroduodenal artery (68.8%, 11/16) and pancreaticoduodenal artery (31.2%, 5/16). Conclusion There are many variations in the distribution and origin of the artery supplying the tail of the pancreas and body. Studying the predominant feeding artery of the tail of the pancreas helps the pancreas intervention in diabetic patients.