在心脏直视手术下行Koch三角测量的研究  

Study on Measu rement of Koch′s Triangle in Patients With Structural Heart Diseases

作　　者：孟令东[1] 周聊生[1] 李晓佳[2] 周凤云[2] 张秋月[2] 

机构地区：[1]山东省千佛山医院心内科,山东济南250014 [2]山东省济南章丘市人民医院心内科

出　　处：《中国心脏起搏与心电生理杂志》2004年第5期352-354,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：观测心脏疾病状态下Koch三角大小 ,并探讨与心脏大小的关系 ,指导临床射频消融术慢径靶点在Koch三角的定位。选择心外科住院手术治疗的先天或后天性心脏病患者 4 1例。术中直视测量Koch三角的各条径线 ,并统计分析其与超声所测心脏大小及患者体重、身高、体表面积的关系。结果 :Koch三角大小与Koch三角的高呈正相关 ,Koch三角的高与右房横径呈正相关 ,冠状窦口到三尖瓣隔侧瓣的距离 (CSO TV)与右房横径呈正相关 ,Koch三角的高与CSO TV呈正相关。结论 :可根据右房大小预测Koch三角大小 ,结合导管影象学上测量Koch三角的高 ,则能判定CSO TV ,以确定慢径消融靶点的位置。To explore the distribution of the target site for the ablation of slow pathways the dimensions of Koch′s triangle in patients with congenital or rheumatic heart diseases wer e observed and sized up,the relation between the size of atrium and that of Koch ′s triangle was calculated .Before operation ,the height,weight,body surface area(BSA) of 41 in-patients with structural heart diseases were measured;The chamber size of left atrium,left ven tricle,right atrium,right ventricle was evaluated by echocardiography.During operation,the dimensions of Koch′s triangle,the tendon of Todaro,the lower limb,the inner diameter of CSO,the height,the distance between the lower rim of CSO and the tricuspid valve(CS O-TV),the distance between the upper rim of CSO and the tendon of Todaro were measured .Results: Descriptive characteristics of the Koch′s triangle were as follows:Tendon of Todaro 20.9±5.2 mm;Height of Koch′triangle 26.5±4.6 mm,Septal leaflet of tricuspid valve 26.9±2.7 mm, CSO -TV 10.9±2.5 mm , the inner diameter of CSO 8.9±1.7 mm;The distance between the up per rim of CSO and tendon of Todaro 8.0±1.7 mm; The height of Koch′s triangle was positively correlate to the area of the Koch′s triangle(r=0.868,P<0 .001) and the size of right atrium (r=0.576,P<0.001).The distance between the lower rim of CSO and the tricuspid valve was also positively correlate to the diameter of right atrium(r=0.548,P<0.001).There wa s no significance about the dimensions of Koch′s triangle between male and female gr oup. Conclusions:The height of Koch′s triangle may be predicted by the size of right atrium and measured fluoroscopically .The distribution of target site of slow pathway may be judged by the height of Koch′s triangle and CSO-TV.

关 键 词：KOCH三角 靶点 心脏直视手术 患者 冠状窦 后天性心脏病 心外科 大小 正相关 结论 

分 类 号：R541[医药卫生—心血管疾病] R654.2[医药卫生—内科学]