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Some innate digital palmar branches could be seen at the pedicle of flyback finger flaps in which veins can be stained to black soon after infusion.It indicated that the blood circulation of arteries to capillaries to veins have completed.The radiogram of flaps showed that the overall transmittancy has been decreased and some blood vessels were visible radiologically.

指背逆行皮瓣的蒂部可见有指掌侧固有动脉的分支,灌注后可见皮瓣内静脉即刻充盈黑染,说明实验皮瓣已完成"血液"从动脉-毛细血管-静脉的循环过程,皮瓣X线造像显示整体透光度减低,皮瓣内有血管显影。

In the last part, we adopt the uniform questionnaire to analyse the incidence, itiology and symptoms of the DVI.The 225 related cases of DVI were studied. We carried on the statistic methods and got the conclusion:(1)Obviously the incidence on the left lower limbs is more serious than that on the right lower limbs of DVI, because of the special feature in anatomy.(2)The varicose veins is not an absolutely necessary symbol of DVI,but only a common symbol.(3)The hard physical labour, standing for a long time or sedentariness everyday for many years, DVT and coldness,wounded or operated, family history are all closely related to DVI.

第三部分通过对225例临床病例的总结,对下肢深静脉瓣膜功能不全的发病情况、病因、症状表现进行了分析,经统计学处理,结论如下:左下肢深静脉的返流程度明显重于右下肢;下肢浅静脉曲张是下肢深静脉瓣膜功能不全的常见症状,而非必有症状;重体力劳动、久坐、久站、DVT、受凉、外伤或手术、家族史与下肢深静脉瓣膜功能不全的发生及程度轻重有密切关系;特别是久坐,其对下肢深静脉瓣膜的损伤不亚于久站和重体力劳动。

And There was no serious complication;②In the course ofinterventional therapy, Direct portal vein angiography demonstrated vena coronaria ventriculi(100%)andgastricveins(65.26%)andvenagastricaposterior38.43%, Angiography demonstrated venacoronariaventriculi communicate esophagus varicose veins, gastric veins and vena gastrica posterior communicategastric varicose veins. vena coronaria ventriculi had only a small percentage of double vein, about30.57%. The sites of vena coronaria ventriculi arising from the portal vein, splenic vein, portosplenic junction, were found in 52.06%、27.39%、20.55% respectively.③12 extrahepaticprotosystemic shunts were found in these patients. Include gastro-nephrosshuntof 3 cases, 7 caseswere splenetic- nephros shunt and 2 cases shown recanalization of umbilical vein .④The averageportal pressure before and after the procedure were 3.87±1.82kPa and 3.64±1.14kPa in 73patients, but to the time of rebleeding, it was 3.96±0.23kPa in the 11 cases.⑤There werethree kinds of variceal outcome: disappearance (54,low degree (19).⑥Spearman logisticanalyse and ANOVAtest shown liver function class, variceal degree of the splenic necrosis area,the blood direction in portal vein before operation and remain small collateral routes were thesignificant factors concerning outcome of varices.⑦The bleeding volume and portalhypertensive gastropathy are main risk factors of rebleeding.⑧The course of livercirrhosis is the risk factor of survival and extrahepatic portosystemic shunt , fine varices are thebeneficial factors to survival.⑨During all cases'followed-up data, the 1, 2, 3, 4, 5 yearcumulative survival rates and rebleeding rates were 17.81%, 28.77%, 38.36%, 43.84%, 47.95%and93.15%,91.78%,86.30%,83.56%,80.82%respectively. Conclusion The interventional disconnection treatment for liver cirrhosis and portalhypertension was designed suitability. It rapidlycontrol bleeding,butpressure of portal vein was notobvious high, perfusion was not low .it was compared with surgery therapeutic that interventionaldisconnection treatment was safe and had a significant clinical effect to hemorrhage and preventfrom rebleeding.

结果:①术后一过性发热62例(84.9%),腹痛腹胀48例(65.8%)是介入断流术常见的并发症,未发生严重并发症;②门静脉造影显示胃冠状静脉、胃短静脉和胃后静脉的曲张分流的出现率是100%、65.26%和38.34%;显示食管静脉曲张主要由胃冠状静脉供血,胃静脉曲张主要由胃短静脉和胃后静脉供血;胃冠状静脉大多数为单支,少数为双支,其双支的出现率分别为30.57%;胃冠状静脉开口于门静脉主干的为52.06%,开口于脾静脉主干的为27.39%和开口于门脾静脉交汇处的为20.55%;③发现胃肾分流3例,脾肾分流7例、腹膜后门腔静脉分流2例,以及CTA检查发现脐静脉开放者2例;④73例患者介入断流术前和术后平均自由门静脉压力分别为3.87±1.82kpa和3.64±1.14kpa,前后比较存在显著性差异;11例再次介入手术患者的术前、术后和复发后的自由门静脉压力分别为4.02±0.24kpa、3.82±0.25kpa和3.93±0.23kpa ,前后比较发现首次术前与术后存在显著性差异,首次术前和复发出血术前门静脉压力比较无显著性差异;⑤介入术后复查曲张静脉转归基本消失54例,轻度19例;⑥Spearman相关分析和Logistic多因素回归分析,肝功能分级、静脉曲张程度、门脉血流方向和残存小侧支四个因素对曲张静脉转归有影响;Spearman相关分析和Logistic多因素回归分析门脉高压性胃病和出血量等因素对复发出血时间有影响;⑦COX回归分析,门体分流和曲张静脉转归两个因素对术后生存有影响;⑧术后随访6-70月,1、2、3、4、5年的累计复发出血率和累计生存率分别为17.81%、28.77%、38.36%、43.84%、47.95%和93.15%、91.78%、86.30%、83.56%、80.82%;结论:介入断流术治疗门脉高压食管胃底静脉曲张有独特的优点,可以快速直接控制曲张静脉出血而门静脉压力无显著增高,保证了肝脏灌注;与外科分流术相比适应证广、损伤轻、术后恢复快,不易遗漏曲张静脉;肝功能分级、曲张静脉程度、门脉血流方向和残存侧支血管对食管胃曲张静脉转归有影响;门脉高压性胃病对复发出血时间有影响;门体分流和曲张静脉转归对生存时间有影响。

There were portal collateral vessels around the main portal vein in 8 patients and among them, there was 1 patient with the varix of gallbladder wall, 2 with gastroepiploic varix, 1 with varix on the bile duct wall, 1 with open of the retroperitoneal-paravertebral vein and the splenorenal vein, and 1 with open of the retroperitoneal-paravertebral vein.

结果 在门脉闭塞后,引起相应血管的纡曲扩张及侧支血管的形成,其中有门脉周围形成门-门侧支循环,胆囊壁静脉的曲张,胃网膜静脉的增粗纡曲,胆管壁静脉的纡曲扩张,腹膜后椎体旁侧支血管的开放,脾-肾静脉短路的开放,胃底食管静脉的曲张。

Results: Anterior to the coronal suture and posterior to the lambdoid suture were two segments of SSS void of bridging vein draining into. The number of bridging veins observed by microanatomy, DSA and CTV was 11.2, 8.9 and 7.0 respectively.

结果:上矢状窦前部和后部分别有一缺乏桥静脉注入段,显微解剖、DSA和CTV观察上矢状窦旁桥静脉的数量分别为11.2支、8.9支和7.0支,DSA和CTV观察发现桥静脉注入上矢状窦处常显示不清。

The operational pathway by cutting down the perihepatic ligament next to the superior border of liver is a quick way with little bleeding, no hurting for diaphragm and hepatic vein, and the secundum porta hepatic can be showed clearly.

观察肝静脉的汇入情况。2结果肝的第二肝门是指肝顶部下腔静脉窝上端,有肝左、中、右静脉和一些附加的肝小静脉注入下腔静脉近端处。

The vein grafts with perivenous support by fibrin glue demonstrated a statistically decrease in neointimal and medial hyperplasia compared with non-supported vein grafts(p.01). immunohistochemical analysis showed that the expression of proliferating cell nuclear antigen was inhibited significantly in fs group compared with ns group. almost intact endothelium was showed in fs grafts(p.01). but in ns grafts there were severe endothelium damages where lymphocytes infiltrated. in ns grafts, the smooth muscle cells were hyperplasia and migrated to intimal, whereas in fs group, the hyperplasia of smooth muscle cells were inhibited and migrated to adventitia.

免疫组化结果显示与ns组相比,fs组移植静脉细胞增殖核抗原表达明显受到抑制;ns组内皮层损伤严重,有淋巴细胞侵润,而fs组内皮层则几乎完好无损(p.01);在ns组平滑肌细胞增殖活跃且向内膜迁移,fs组平滑肌细胞增殖受到抑制,且向外膜迁移;在fs组移植静脉外膜有丰富的成熟微小血管网形成,但是在ns组,微小血管数量则非常少。

Some innate digital palmar branches could be seen at the pedicle of flyback finger flaps in which veins can be stained to black soon after infusion.It indicated that the blood circulation of arteries to capillaries to veins have completed.The radiogram of flaps showed that the overall transmittancy has been decreased and some blood vessels were visible radiologically.

指背逆行皮瓣的蒂部可见有指掌侧固有动脉的分支,灌注后可见皮瓣内静脉即刻充盈黑染,说明实验皮瓣已完成&血液&从动脉-毛细血管-静脉的循环过程,皮瓣X线造像显示整体透光度减低,皮瓣内有血管显影。

These showed that there was an accumulation of agent in strangulated ischemic bowel segment in strangulated loop group and mesenteric venous occlusion group.All results suggest that radionuclide visualization with SPECT could be a valuable method for early diagnosis of acute intestinal strangulation of strangulated loop type and mesenteric venous occlusion type.

本实验结果提示:闭袢型和静脉阻塞型绞窄缺血肠段早期有显像剂的聚集;SPECT的核素显像技术可作为早期诊断闭袢型和肠系膜静脉阻塞型肠梗阻有价值的辅助手段。

Meanwhile, it receives one or more veins and is closely correlated with theⅥ,Ⅸ,Ⅹ,Ⅺcranial nerves on the way. With the development of microsurgery of the petro-occipital and jugular foramen regions and the application of diagnosis and therapy of skull base and cavernous sinus diseases via IJV approach, it is necessary to study the imaging anatomy of IPS, its important adjacent nerves and its anastomosis with related veins in detail.

随着岩斜区及颈静脉孔区肿瘤切除等显微外科手术的开展以及经颈内静脉诊断和介入治疗颅底和海绵窦病变的逐渐应用,有必要对IPS的影像解剖学、重要神经毗邻及其与相关静脉的吻合情况进行详尽研究。

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