【摘要】 目的:为电视胸腔镜肺门迷走神经切断治疗支气管哮喘提供解剖依据。方法:观察4例甲醛固定尸体的双侧肺门迷走神经的分支,解剖1例成人新鲜尸体,重点观察双侧迷走神经分支进入肺门的情况,及其与临近的解剖关系。并在电视胸腔镜下解剖雄犬2条,了解犬的肺门迷走神经分支是否与人相似,进行实验动物模型的手术。结果:胸腔内迷走神经主干在肺根处分前后支进入肺门支配支气管,个体不同分支数量和分支直径有所不同,左右侧不同,肺前支1～3支,肺后支2～6支,左侧分支直径比右侧略大,两侧在肺根的解剖关系相同。犬双侧肺门迷走神经分支的解剖与人相似。结论:肺门迷走神经分支,在肺根处从主干分出前支及后支,容易辨认,但要注意肺前支,因其分支少且细小,手术中不要遗漏。还要注意避免损伤支气管动静脉等周围结构,特别是左侧要避免损伤喉返神经。更多还原

【Abstract】 Objective: To provide anatomic basis for vagotomy of hilum of lung under video-assisted thoracoscope surgery on treatment of bronchus asthma. Methods: Four corpses fixed by formalin were dissected for observation on bilateral vagus nerve branches of hilum of lung. One fresh adult corpse was dissected to observe especially how the vagus branches enter into hilum of lung and its relationship nearby. Two male dogs were dissected to Observe whether their vagus nerve branches of hilum of lung were similar to human being’s, and then the operation on animal model were carried on. Results: Thoracic vagus nerves separated into front (branch) and back (branch) from the position of lung root to supply the bronchus. The numbers and diameters of branches of different individuals and both sides were different, 1～3 branches in the front, 2～6 at the back. The diameter of left side of the lung branches was wider than the right side’s. The anatomy relationship of both sides of the vagus nerves was the same at hilum of lung. The anatomy distribution of both sides branches of the dog’s vagus nerves of hilum of lung was similar to the human being’s. Conclusions: The vagus nerve of hilum of lung separate into the front branch and the back branch at lung root, which is recognized easily. The front branch should be paid more attention because of its few numbers and tiny diameter. Don’t omit it in operation. The injury of surrounding structure (bronchial artery and vein) should also be avoided, especially the injury of recurrent laryngeal nerves.更多还原