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目的观察正常人胸导管在脊柱T4～T12节段的解剖走行,并测量相关解剖学参数,为胸腔镜下胸椎前路手术安全处理胸导管提供依据。方法解剖30具正常成人尸体标本,观察胸导管在脊柱T4～T12节段的解剖走行,测量T4～T12各节段右侧肋骨头到胸导管右缘的长度,以此描述胸导管在T4～T12节段的走行。结果胸导管多于T12右膈脚处起自乳糜池,经膈主动脉裂孔入胸腔后纵隔后,在胸主动脉与奇静脉之间,形成向椎体左侧凸出的弯曲,沿脊柱胸段前面上行,在T5椎体水平越过主动脉后方由椎体右侧越过中线渐向左侧移行,在T4水平紧贴纵隔胸膜及椎体左前方垂直上行。结论胸导管在T4～T11节段上行过程中向椎体的左侧凸出,胸导管T7～T11段多为单根,走行固定,变异少。胸腔镜下胸椎前路手术时更容易在此节段安全处理胸导管。
Objective To observe the anatomy of normal thoracic duct in the segment of T4 ~ T12 and to measure the relevant anatomical parameters to provide a basis for thoracoscopic anterior thoracic surgery for the safe management of thoracic duct. Methods Thirty adult cadaver specimens were dissected and the anatomy of the thoracic duct in the segment from T4 to T12 was observed. The length of the right rib to the right edge of the thoracic duct from T4 to T12 was measured. T12 segment of the walk. Results Thoracic duct more than T12 from the chin on the right phrenic foot pool, through the aortic aorta into the posterior mediastinum, between the thoracic aorta and azygos vein, the formation of convex curvature to the left vertebral body, along the spine chest Upward in front of the segment, at the level of T5 vertebral body across the aorta from the right side of the vertebral body through the midline to the left shift, T4 level close to the mediastinal pleura and vertical left vertebral upward. Conclusion The thoracic duct protrudes to the left of the vertebral body during the ascending of T4 ~ T11 segment. The thoracic duct is mostly single in the T7 ~ T11 segment, with a fixed line with little variation. Thoracoscopic anterior thoracic surgery easier to safely handle thoracic duct in this segment.