胰头后面神经分布的应用解剖学研究-东南大学学报医学版

胰头后面神经分布的应用解剖学研究

单位：东南大学基础医学院,人体解剖学教研室,江苏,南京,210009

分类号：R322.491, R322.85

出版年·卷·期（页码）：2006·25·第一期（20-23）

摘要：

目的:观察胰头后面的神经分布,探讨胰头癌沿神经浸润转移的解剖学基础,为临床上清除由于胰头癌神经浸润转移所致的残留癌以及胰源性疼痛止痛术等提供相关的应用解剖学资料.方法:运用大体解剖学方法观测了30具成人尸体胰头后面神经分支的来源和分布特征.结果:(1)胰头后面的神经分支主要来源于右腹腔神经节(27例)、腹腔丛右侧半(20例)和肝丛(16例),少数发自肠系膜上丛(14例).(2)胰头后面神经分布形式以成丛型,即"胰头丛"占多数(24例),仅有6例为不成丛型.(3)"胰头丛"的位置较恒定,紧贴于胰头后面,邻接下腔静脉和左肾静脉的末段.胰头后面神经分支进入胰头后面腺体的部位以右上、下象限为主(分别有21例和26例),其次为左下象限(14例),而左上象限最少(3例).结论:胰头后面的神经分布丰富,其来源和分布具有一定的规律性和特点,为胰头癌神经浸润转移和术后局部肿瘤复发提供了可能,也是导致中、晚期胰腺癌剧烈疼痛的形态学基础.

Objective To study distribution of nerve branches on the back of the head of pancreas(BHP) and provide anatomical basis for radical operation of nerve invasion and metastasis of carcinoma of the head of pancreas.Method The origin and morphological features of nerve branches on the BHP in 30 corpses were observed by gross anatomy.Results Nerve branches on the BHP mainly came from right celiac ganglion(27 cases),right part of celiac plexus(20 cases) and hepatic plexus(16 cases).A majority of them formed the plexus pancreaticus capitalis(80%) which lay between BHP and the end part of left renal vein.Conclusions The superior mesenteric plexus is also an important source of those nerve branches.Morphological study of nerve branches on the BHP provides an important anatomical basis for clinical operation to clear nerve invasion and metastasis of carcinoma of the head of pancreas,also explains the tremendous pain caused by pancreatic carcinoma of middle and advanced stage.

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