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The distribution and arrangement of the segmental bronchi and blood vessels of the lower lobe of right lung have been studied in fifty adult cadavers,by the same methods as those for the right upper and middle lobes reported previously. 1.Five segmental bronchi are constantly present in right lower lobe as described in textbook.Subapical bronchus (B~*) has been identified only 46% in this series of specimens. The prevailing pattern of the branches of the apical bronchus is a bifurcation of B~6c,B~6a+b. In 10%... The distribution and arrangement of the segmental bronchi and blood vessels of the lower lobe of right lung have been studied in fifty adult cadavers,by the same methods as those for the right upper and middle lobes reported previously. 1.Five segmental bronchi are constantly present in right lower lobe as described in textbook.Subapical bronchus (B~*) has been identified only 46% in this series of specimens. The prevailing pattern of the branches of the apical bronchus is a bifurcation of B~6c,B~6a+b. In 10% of the medial basal segmental bronchus,its medial ramus (B~7b) is deep to the basal veins.Resection of this type of medial basal segment is considered to be harzardous. Posterior ramus of the lateral basal segmental bronchus (B~9c or BX~*9) has been found in 12% of the specimens.This has not been reported by E.A.Boyden or by other Chinese writers. 2.The number and pattern of origin of the segmental arteries of the right lower lobe are more complex than those of the segmental bronchi.Only in 14% of the speci- mens,the segmental arteries are the same in number and origin as the segmental bronchi, the rest being variable. Same as B~6,the prevailing pattern (58%) of the branches of the apical segmental artery is a bifurcation of A~6c,A~6a+b.In 48% of the specimens,the anterior basal segmental artery arises in a common stem with A~7 or A~7a.Comparing with other re- ports,this fact is significant. The total number of subapical segmental arteries (A~*) in this series of specimens is larger than its accompaning subapical segmental bronchi.Occasionally,the subapical artery arises from the beginning part of the posterior basal segmental artery. The number of the posterior ramus of the posterior basal segmental artery (A~(10)c or accessory subsuperior artery) is not always the same as its accompaning artery.It may arise from A~9 or the pars basalis of the right pulmonary artery. 3.The veins of the right lower lobe are same as the right upper and middle lobes, situated between segments or subsegments.They usually form two main veins which are drained into the right lower pulmonary vein.The basal veins may be classified into three types;the uncomplicated type is the prevailing pattern which occurs in 66%. 采用考查右肺上叶和中叶的方法考查了50例成年右肺下叶的支气管和血管。右下叶恒定的段支气管有五支,即尖段支气管(B~6),内侧基底段支气管(B~7),前基底段支气管(B~8),外侧基底段支气管(B~9),后基底段支气管(B~(10))。尖下段支气管(B~*)的出现率为46%。B~6最常见的分支型式是单干类二分支型(B~6c,B~6a+b),为84%。B~7的内侧支(B~7b)经右下肺静脉后方(深面)分布于椎旁面的为10%,在施行内侧基底段切除时应予注意,以免损伤右下肺静脉。外侧基底段支气管的后支(即BX~*a)在右下叶的出现率为12%。本文讨论了BX~*(10)和BX~*(9)的命名问题。右下叶动脉的分支数目和分支型式与支气管相同的仅为14%,彼此数目相同分支型式不同的为26%,其余动脉的分支数目和分支型式均不一致。尖段动脉(A~6)的常见分支型式与尖段支气管一样,是单干类的二分支型(A~6c,A~6a+b),为58%。前基底段动脉(A~8)与内侧基底段动脉(A~7)或内侧基底段动脉外侧支(A~7a)共干的占48%,与其它作者的结果之间有显著差别。尖下段动脉(A~*)的来源不一,它的总支数较B~*多,除A~*与... 采用考查右肺上叶和中叶的方法考查了50例成年右肺下叶的支气管和血管。右下叶恒定的段支气管有五支,即尖段支气管(B~6),内侧基底段支气管(B~7),前基底段支气管(B~8),外侧基底段支气管(B~9),后基底段支气管(B~(10))。尖下段支气管(B~*)的出现率为46%。B~6最常见的分支型式是单干类二分支型(B~6c,B~6a+b),为84%。B~7的内侧支(B~7b)经右下肺静脉后方(深面)分布于椎旁面的为10%,在施行内侧基底段切除时应予注意,以免损伤右下肺静脉。外侧基底段支气管的后支(即BX~*a)在右下叶的出现率为12%。本文讨论了BX~*(10)和BX~*(9)的命名问题。右下叶动脉的分支数目和分支型式与支气管相同的仅为14%,彼此数目相同分支型式不同的为26%,其余动脉的分支数目和分支型式均不一致。尖段动脉(A~6)的常见分支型式与尖段支气管一样,是单干类的二分支型(A~6c,A~6a+b),为58%。前基底段动脉(A~8)与内侧基底段动脉(A~7)或内侧基底段动脉外侧支(A~7a)共干的占48%,与其它作者的结果之间有显著差别。尖下段动脉(A~*)的来源不一,它的总支数较B~*多,除A~*与同数的B~*伴行外,还有三支A~*伴两支B~*的现象。后基底段动脉后支(A~(10)c)(即AX~*(10))的起源和支数与尖下段动脉有相似的现象。尖下段动脉和后基底段动脉的后支与它们所伴行的支气管之间,在起源上和分支数目上存在着异源异数或异源同数或同源异数的关系。右肺下叶的静脉与右上叶和中叶一样,行于段间或亚段间,汇集成尖段静脉、上基底静脉和下基底静脉三大支。上、下基底静脉先汇集成总基底静脉,再与尖段静脉组成右下肺静脉。上基底静脉和下基底静脉的组成型式,本文分为正常型、分裂型和异常型。正常型是常见的型式,为66%。右肺下叶的静脉与支气管和动脉间缺少联系。动脉与支气管在分支型式上不尽相同,但在分布上却紧密伴随。 From February 1961 to September 1977, 220 lung cancer patients were admitted and treated surgically in our hospital.The 5-year survival rate of the 88 follow-up cases in this series of patients is 29.5%, and the 10-year survival rate of the 49 follow-up cases 20.4%.Among the 10 patients surviving for more than 10 years after resection of the cancers, 9 were male and 1 was female. These 10 patients were aged 30-68 years ( with an average of 49 years) .Pulmonary lobectomy was performed in 8 patients and... From February 1961 to September 1977, 220 lung cancer patients were admitted and treated surgically in our hospital.The 5-year survival rate of the 88 follow-up cases in this series of patients is 29.5%, and the 10-year survival rate of the 49 follow-up cases 20.4%.Among the 10 patients surviving for more than 10 years after resection of the cancers, 9 were male and 1 was female. These 10 patients were aged 30-68 years ( with an average of 49 years) .Pulmonary lobectomy was performed in 8 patients and pneumonectomy in 2 patients. Pathologically the resected specimens were found to be 8 squmous carcinoma, 1 adenocarcinom'a and 1 undifferential cell carainoma respectively. Only in 2 of the 10 patients were there lymph node metastases found in the pulmonary hila.The more significant factors which can influence the survival rate are discussed. The more important factors in favor of a long postoperative survival rate include the tumor size ( tumors of less than 3 cm in diameter seem to have better prognosis ), the time interval between the date of operation and the discovery of symptomes(if it is less than 3 months the chance of a long survival rate is greater ) , the tumor pathological type and the type of operative resection and postoperative treatment.If it is a squmous carcinoma without lump node metastases, and if radical resection of the tumor is carried out with maximal conservation of the pulmonary function and proper postoperative treatment, it may offer a better outlook. 在我院收治的220例肺癌病人中,术后得到随访十年以上仍存活者10例,术后十年存活率为20.4%。其中鳞癌8例,腺癌及未分化癌各1例。作者认为,一般说来,50岁左右的男性肺癌病人在术后长期存活的可能性似较大些。发现病变在3个月内手术切除的对予后有利。病变部位属边缘型,而肿瘤直径小于3厘米;细胞形态为鳞癌,尤其是乳头状鳞癌,未发现纵隔肺门淋巴结转移者,术后长期存活的机会较多。术后综合治疗及时,注意全身状况的改进,这样有利于肺癌病人手术切除后的长期活存。 Three patients suffering from chondrosarcoma of the upper end ofthe humerus, synovial sarcoma and cavernous hemangioma of the armrespectively were presented. The aims of the operation were to resect the tumor en bloc byamputation and replant the distal normal part of this limb so as toremove the tumor radically and retain the function of the limb as muchas possible. We believe that this operation is advisable in some tumorsof the upper limb when the resection of the tomor and its surroundingsoft tissues... Three patients suffering from chondrosarcoma of the upper end ofthe humerus, synovial sarcoma and cavernous hemangioma of the armrespectively were presented. The aims of the operation were to resect the tumor en bloc byamputation and replant the distal normal part of this limb so as toremove the tumor radically and retain the function of the limb as muchas possible. We believe that this operation is advisable in some tumorsof the upper limb when the resection of the tomor and its surroundingsoft tissues must be done radically and can be done successfully. Themain arteries and veins of the limb should be anastomosed after resection.If the nerves are near the tumor, they should be resected and resuturedrespectively; if distant, they could be preserved in situ. 本文报告上肢肿瘤段切除与远侧肢体再植术3例的近期效果。讨论了手术患者的选择,切除范围和神经血管的处理。
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