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侧胸部小切口的应用解剖

Applied anatomy of the small incision in thoracotomy

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【作者】 张晓明应勖朱晞袁张根胡伟恩李浒毛宝根

【Author】 ZHANG Xiao-ming, YING Xu,ZHU Xi, et al. Institute of Anatomy, Medical College of Zhejiang University, Hangzhou 310031,Ch ina

【机构】 浙江大学医学院解剖学教研室杭州市第一人民医院胸外科杭州市第一人民医院胸外科 浙江杭州310031浙江杭州310031浙江杭州310031

【摘要】 目的 :为侧胸部小切口手术方法提供应用解剖学基础。方法 :解剖观测 2 3例 (46侧 )常规防腐尸体标本的胸前外侧区内胸背神经、胸背血管、胸长神经及胸外侧血管的走行、分支及分布和体表定位。结果 :侧胸部背阔肌和胸大肌之间的三角形间隙内 ,胸背神经横径 :(2 .6± 0 .5 )mm ;暴露长度 (进入背阔肌前 ) :(4.7± 0 .7)cm ;均于第 4或 5肋间隙进入背阔肌 ;与其伴行的胸背动脉压径 :(3 .0± 0 .6)mm。胸长神经横径 :(2 .4± 0 .6)mm ;暴露长度 :(4.6± 0 .7)cm ;均于第 4或第 5肋间隙入前锯肌。面胸外侧动、静脉于胸小肌下缘中部第 3、4肋间隙穿出胸小肌后也暴露于此三角内 ,其压径 (2 .7± 0 .4)mm ;暴露长度 :(3 .9±0 .7)cm。结论 :胸背神经、胸背血管、胸长神经、胸外侧血管在背阔肌与胸大肌之间的三角形间隙内有固定行径 ,进行侧胸部小切口时 ,应避免上述结构损伤。

【Abstract】 Objective: To provide anatomical basis for the applic ation of small incision in thoracotomy.Methods: The origins, lengths, diameters, courses, dist ributions and surface locations of thoracodorsal nerve, thoracodorsal vessels, l ong thoracic nerve and lateral thoracic vessels were observed and measured on 23 (24 sides) cadaveric specimens.Results: There was a tri angle composed of latiss imus dorsi and greater pectoral muscle at lateral thoraces.The lengths of expose d thoracodorsal nerves in this triangle averaged 4.7±0.7 cm, while its diameter averaged 2.6±0.5 mm. They entered into latissimus dorsi at 4th or 5th intercostal space. The diameters of companion thoracodorsal artery averaged 3.0±0.6 mm.The diameters of long thoracic nerve averaged 2.4±0.6 mm, and the l ength of exposed long thoracic nerve in the triangle averaged 4.6±0.7 cm.They pierced into serratus anterior at 4th or 5th intercosal space. The lateral thora cic arteries and veins passed thorough the triangular space between pectoralis m ajor muscle and latissimys dorsi after they emerged from the middle of lower edg e of pectoralis minor muscle at 3rd rib.The lengths and diameters of exposed la teral thoracic artery averaged 3.9±0.7 cm and 2.7±0.4 mm. Conclusi ons: In the triangular space, the courses of thoracodorsal nerve, thoracodorsal artery and v ein, long thoracic nerve, lateral thoracic artery and vein were regular.So the d amage of these structures should be avoided in application of small incision in thoracotomy.

【关键词】 小切口侧胸部应用解剖
【Key words】 small incisionthoracotomyapplied anatomy
【基金】 杭州市卫生局科研基金资助项目 (0 0B0 0 3)
  • 【文献出处】 中国临床解剖学杂志 ,Chinese Journal of Clinical Anatomy , 编辑部邮箱 ,2001年04期
  • 【分类号】R655
  • 【被引频次】15
  • 【下载频次】103
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