摘要
目的:为临床经胸骨上段显露脊柱颈胸段提供解剖学基础。方法:对40具成人尸体模拟经胸骨上段显露颈胸段脊柱的入路进行解剖,并进行有关的数据测量。结果:甲状腺中静脉有48.8%的人一侧缺如。胸骨劈开后撑开的横径为(60.8±1.64)mm。两侧胸膜在前界中段之间有分离型、接近型、接触型和掩复型,后两者占50.4%。食管在T3椎体平面超出气管左缘(0.5±0.08)cm。胸导管由颈血管鞘后方到注入静脉的行程位于颈静脉角三角区。左、右侧喉返神经分别有94.5%、59.6%走行在气管食管沟内,并与甲状腺下动脉有复杂的关系。胸骨角正对T4/5椎间盘、T4下1/3和T5上1/3椎体(62.5%)水平,喉返神经左、右侧返折点分别平对T3/4椎间盘、T4椎体(75.6%)和T1/2椎间盘、T2椎体(82.0%),主动脉弓、右锁骨下动脉上缘分别对T3(73.7%)和T1椎体(70.0%)水平,经胸骨上段入路的颅侧和尾侧分别平对C3/4椎间盘、C4椎体(75.6%)和T3椎体、T3/4椎间盘(86.8%)。结论:经胸骨上段显露脊柱颈胸段具有暴露充分,操作方便,具有推广价值。
Objective： To provide anatomic data for the trans-upper-stemal approach to the cervicothoracic junction. Methods： 40 cadaveric specimens were dissected, according to the operative procedure of the trans-upper-stemal approach to the cervicothoracic junction, and then related structures were observed and measured. Results： The rate of absence of the unilateral middle thyroid vein was 48.8%. After splitting the sternum, the diameter between segments of the sternum was about 60.8±1.64 mm. The middle part of the anterior border of bilateral pleurae can be described as separated, closed, contacted and overlapped types respectively. 50.4% specimens were last two types. The distance between the left border of the esophagus and the trachea was 0.5±0.08 cm. Thoracic duct located in the triangle region of jugular vein angle all the way from the behind of carotid sheath to the point draining into the vein. For 94.5% and 59.6% of specimens, the left and right recurrent laryngeal nerve located in the esophagotracheal groove respectively and formed a complicated relationship with the inferior thyroid artery. The sternal angle located at the level of T4/5 disc, the lower 1/3 of T4 and the upper 1/3 of the T5 level （62.5%）. The recurrent point of the left recurrent laryngeal nerve located at T3/4 disc, T4 level （75.6%）, while the right at T1/2 disc, T2 level （82.0%）. The upper border of the aortic arch located at T3 level （73.7%）, and the upper border of the right subclavian artery at T1 （70.0%） level. The cephalic and Caudal border of the surgical area concerning with trans-upper-stemal approach was at C3/4 disc, C4 （75.6%） level and T3, T3/4 disc level （86.8%） respectively. Conclusions： The trans-upper-stemal approach to the cervicothoracic junction is valuable for its fully exposure and easy operation during the operation.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2007年第6期611-614,共4页
Chinese Journal of Clinical Anatomy
关键词
颈胸段
经胸骨上段入路
应用解剖
cervicothoracicjunction
trans-upper-stemal approach
applied anatomy
