摘要
目的 通过对胆道螺旋CT片的客观测量 ,对肝门部胆管进行立体定位 .方法 以肝内外胆管显影清楚 ,诊断为肝内外胆管结石的CT片 117份作为研究对象 .测量左右肝管汇合处及其体表投影点至剑突尖端的距离 ,计算出左右肝管汇合处至剑突尖端连线的长度及其与人体横断面、冠状面、矢状面的夹角 ,对肝门部胆管进行立体定位 .并比较男女之间的差异 .结果 ①左右肝管汇合处在剑突尖端平面下方 19.8± 16 .1mm .②左右肝管汇合处位于正中矢状面右侧 4 5 .5± 10 .1mm .③左右肝管汇合处在前后方向上位于距前体表 81.7± 13.0mm .④左右肝管汇合处与剑突尖端连线长度为 94 .4± 12 .1mm .⑤左右肝管汇合处与剑突尖端连线与横断面夹角为 12 .4± 9.9度 .⑥左右肝管汇合处与剑突尖端连线与冠状面夹角为 76 .6± 11.3度 .⑦左右肝管汇合处与正中矢状面夹角为 30 .2± 6 .7度 .结论 术前CT定位定向对PTCS穿刺有指导意义 ,采取剑突下肋缘点穿刺时 ,在穿刺深度上男女有显著差异 。
Objective In order to locate the target bile ducts during PTCS to reduce heamorrhage and bile leakage. Methods Selecting the good films of spiral CT on bile ducts, which were diagnosed cholangiolithiasis, from Apr 1998 to Jan 2003 in the first affiliated hospital of Guangzhou Medical College. Making the point at the xiphoid as the basic point (O point), and the confluence of the left and right bile duct as the key point (K point). Measuring the length of the vertical line segment (A line segment) from K point to the transverse section through A point, B line segment to the medial sagittal section, C line segment to the sagittal section through K point, D line segment to the medial anterior line in the transverse section through K point, E line segment was from K point to A point. Calculating the degrees of three corners: the first was the corner between E line and the sagittal section, the second between E line and the transverse section, the third between E line and the sagittal section. Comparing the differences between men and women by using t-test. Results There were 117 patients films. The A line segment is 19.8±16.1mm. B line segment is 45.5±10.1mm. C line segment is 81.7±13.0mm. D line segment is 90.8± 12.4 mm. E line segment is 94.4±12.1mm. The first corner is 12.4±9.9 degree. The second is 76.6±11.3 degree. The third is 30.2±6.7° degree. Conclusions PTCS' needle should point at the hepatic hilum into the objective bile ducts with an acute angle. There is significant difference between men and women in the puncture deep length. Localization of bile ducts by the spiral CT should be useful for PTCS.
出处
《现代临床医学生物工程学杂志》
2003年第5期396-398,共3页
Journal of Modern Clinical Medical Bioengineering
