摘要:
目的 观察奇静脉系的形态特征,对非典型奇静脉系进行解剖学分类,为纵隔、胸腔大血管疾患的诊治提供参考依据.方法 解剖30具人体标本,分别测量奇静脉、半奇静脉、副半奇静脉起点及终点的直径,观察其终点与胸椎序数的对应关系.结果 经典型奇静脉系24例,即该系具有完整的奇静脉、半奇静脉、副半奇静脉.非典型奇静脉系6例,根据其形态进一步分为:a型2例,即倒"Y"字型奇静脉系,奇静脉由左、右腰升静脉及下4位肋间静脉在脊柱前方合成;b型2例,即单柱型奇静脉系,半奇、副半奇静脉发育缺如,仅有1条奇静脉在脊柱前方上行;c型1例,即半奇静脉缺如,副半奇静脉注入左头臂静脉;d型1例,即奇静脉伴双上腔静脉变异.奇静脉终点直径(10.39 ±1.98)mm,主要平对T4(83.3%);半奇静脉终点直径(8.51 ±2.28)mm,主要位于T7~T10水平;副半奇静脉终点直径(6.29 ±1.56)mm,位于T4~T8水平.结论 对非典型奇静脉系的研究,是对该系既往分型的补充,不仅为临床检查过程中识别该系变异提供参考,也为纵隔手术、纵隔镜检查、胸椎外伤的诊治等提供数据支持.%Objective To investigate the morphology and classification of the atypical azygos venous system,and to provide reference for diagnosis and treatment of mediastinal and thoracic vascular diseases.Methods Thirty cadavers were perfused with 10%formalin solution, and immersed in the solution for one month before dissection.The vertebral levels of termination and diameters of the azygos,hemiazygos and accessory hemiazygos veins were examined.Results There were 24 cases of classical azygos venous system,which contained the azygos, hemiazygos and accessory hemiazygos veins.And there were 6 cases of atypical azygos venous system,which were further divided into 4 sub-groups.Namely,type a(2 cases)which showed an inverted"Y"shape;type b(2 cases)which was single column with hemiazygos and ac-cessory hemiazygos veins absent;type c(1 case)which showed an accessory hemiazygos vein draining into the left brachiocephalic vein;and type d(1 case)with azygos vein and double superior vena cava variation.Diameters of termination of the azygos,hemiazygos and accessory hemiazygos veins were(10.39 ±1.98)mm,(8.51 ±2.28)mm,and(6.29 ±1.56)mm,respectively.The vertebral levels of termination of the azygos,hemiazygos and accessory hemiazygos veins were T 4(83.3%),T7to T10,T4to T8respectively.Conclusion All morphometrical diameters and their termination levels can be used during preoperative CT evaluations before planning invasive mediastinal procedures.The re-sults of this study could be helpful in mediastinal surgery,mediastinoscopy and the surgery of the deformations of the vertebral column in the thoracic cavity.