CAJ | 학술논문

目的：分析肠系膜下动脉（IMA）解剖特点，探讨介入选择性插管优化方案。方法分析132例（中位年龄59.5岁）接受全腹部增强CT检查且肠系膜上下动脉均正常的病人影像资料，比较不同性别间肠系膜下动脉开口直径、开口距离髂动脉分叉垂直径、开口相对应腰椎平面位置及髂动脉分叉角度的差异。另外选择80例病人进行选择性IMA插管，其中40例采用C2导管成袢技术；另外40例采用非C2导管成袢技术，比较两组插管成功率，并分析插管失败原因。结果肠系膜上、下动脉均正常的病人中，男性病人的IMA开口的直径、开口距离髂动脉分叉的垂直径均大于女性病人的[男女比分别为（31.5±5.5） mm∶（27.2±4.7） mm；（42.9±6.7） mm∶（40.1±7.8） mm；均P＜0.05]，肠系膜下动脉开口部位及髂动脉分叉角度在两组间差异无统计学意义（P＞0.05）。80例选择性肠系膜下动脉插管，采用C2导管成袢技术组的40例均选择性插管成功，而非C2导管成袢技术组，成功25例，失败15例（其中男性4例，女性11例），两组间比较成功率差异有统计学意义（P＜0.01）。结论肠系膜下动脉管径较细，开口位置低，选择性插管采用C2导管成袢技术可提高成功率。
목적：분석장계막하동맥（IMA）해부특점，탐토개입선택성삽관우화방안。방법분석132례（중위년령59.5세）접수전복부증강CT검사차장계막상하동맥균정상적병인영상자료，비교불동성별간장계막하동맥개구직경、개구거리가동맥분차수직경、개구상대응요추평면위치급가동맥분차각도적차이。령외선택80례병인진행선택성IMA삽관，기중40례채용C2도관성번기술；령외40례채용비C2도관성번기술，비교량조삽관성공솔，병분석삽관실패원인。결과장계막상、하동맥균정상적병인중，남성병인적IMA개구적직경、개구거리가동맥분차적수직경균대우녀성병인적[남녀비분별위（31.5±5.5） mm∶（27.2±4.7） mm；（42.9±6.7） mm∶（40.1±7.8） mm；균P＜0.05]，장계막하동맥개구부위급가동맥분차각도재량조간차이무통계학의의（P＞0.05）。80례선택성장계막하동맥삽관，채용C2도관성번기술조적40례균선택성삽관성공，이비C2도관성번기술조，성공25례，실패15례（기중남성4례，녀성11례），량조간비교성공솔차이유통계학의의（P＜0.01）。결론장계막하동맥관경교세，개구위치저，선택성삽관채용C2도관성번기술가제고성공솔。
Objective To analyze the anatomical features of inferior mesenteric artery (IMA) and explore the optimal proposal of the selective IMA intubation. Methods 132 cases (median age 59.5 years old) whose superior mesenteric artery and IMA showed normal on enhanced CT were selected. The diameter of IMA opening, vertical lengths from the IMA openning to the common iliac artery bifurcation, lumbar plane corresponding to the IMA openning, and angle of iliac artery bifurcation were compared between male and female patients. Eighty patients underwent selective IMA intubation, among 40 of the 80 cases looped C2 catheter was used , and non-looped C2 catheter was used in the another 40 cases. Results The diameter of IMA opening and the vertical lengths from common iliac artery bifurcation were larger in male than in female patients (31.5±5.5 mm vs. 27.2±4.7 mm, P<0.05;42.9±6.7mm vs.40.1±7.8mm, P<0.05 respectively).The differences in the opening position of IMA and angle of iliac artery bifurcation did not differ between male and female patients (P>0.05). Forty cases successed by using the techniques of looped C2 catheter.Twenty-five cases successed and Fifteen cases failed (male 4 cases, female 11 cases) by using the techniques of non-looped C2 catheter. There was statistical significance in success rate between the two groups (P<0.01). Conclusion IMA has a smaller diameter and low opening position. Selectively catheterization by using C2 catheter looping technology can improve the success rate.