在心脏直视手术下儿童Koch三角的测量研究  

Measurements of Koch′s Triangle in Children With Structural Heart Disease.

作　　者：孟令东[1] 郑司亮[2] 周聊生[1] 

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》2005年第3期207-209,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：观测儿童心脏疾病状态下Koch三角的大小及其变化,指导儿童房室结折返性心动过速慢径的射频消融法的定位。选择心外科住院手术治疗先天性心脏病儿童患者19例。术中直视测量Koch三角的各条径线。计算Koch三角各径线与身高、体重、体表面积及超声所测心脏各心腔大小之间两变量间的关系。结果:Koch三角的高12.7±4.6mm、冠状窦口(CSO)下缘到三尖瓣(TV)隔瓣的最近距离6.3±2.5mm;Todaro腱长13.7±2.4mm、TV隔瓣长13.9±2.7mm、CSO上缘到Todaro腱的最近距离4.3±1.7mm、CSO直径6.8±1.7mm。Koch三角的大小、Koch三角的高、CSOTV的距离与年龄、体重、身高等呈相关关系;CSO直径、Todaro腱长、CSO到Todaro腱长度与上述因素无相关关系。结论:儿童Koch三角受多种因素影响,与成人的Koch三角存在明显大小差异,对儿童患者行慢径射频消融一定要在充分考虑射频消融术的风险效益后进行。To determine the distribution of the target site for the ablation of slow pathways to guide the radiofrequency catheter ablation(RFCA) of atrioventricular nodal reentrant tachycardial(AVNRT) ,we observed and sized up the dimensions of Koch′s triangle in children patients with congenital heart diseases,explored the related factor and compared with that in adults. Before operation,the height,weight,body surface area(BSA) of 19 in-patients with structural heart diseases were measured. The champer size of left atrium ,left ventricle,right atrium,right ventricle was evaluated by echocardiography.During operation, we measured 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(CSO-TV),and the distance between the upper rim of CSO and the tendon of Todaro.Then with SPSS 8.0 deplore the relation between the dimension of Koch′s triangle and that of each chamber of heart,height,weight and BSA .Results: Descriptive characteristics of the Koch′s triangle in children were as follows: tendon of Todaro 13.7±2.4 mm,the height of Koch′s triangle 12.7±4.6 mm,the septal leafle of tricuspid valve 13.9±2.7 mm, the distance between the lower rim of CSO and the tricuspid valve 6.3±2.5 mm,the inner diameter of CSO 6.8±1.7 mm,and the distance between the upper rim of CSO and the tendon of Todaro 8.0±2.5 mm.The height of Koch′s triangle was most positively correlate to the area of the Koch′s triangle. The most correlate factor to CSO-TV was age.There was no significance about the dimension of Koch′s triangle between male group and female group.Conclusions: Great discrepancy exists in the dimensions of Koch′s triangle between adults and children. The dimension of Koch′s triangle in children is affected by many factors.The risk and benefit in children must be adequately considered before RFCA of AVNRT.

关 键 词：心血管病 解剖学 KOCH三角 消融 射频电流 房室结折返性心动过速 慢径 儿童 

分 类 号：R654[医药卫生—外科学] R541.71[医药卫生—临床医学]