经胸骨柄“U”形开窗入路显露上胸椎的应用解剖  

Applied Anatomy of the "U" Fenestration in Sternal Manubrium to Reveal Upper Thoracic Vertebra

作　　者：庄平[1] 丁真奇[1] 康两奇[1] 郭志民[1] 

机构地区：[1]解放军第175医院(厦门大学附属东南医院)骨科

出　　处：《解剖与临床》2008年第3期162-164,共3页Anatomy and Clinics

摘　　要：目的：研究经胸骨柄“U”形切除入路显露上胸椎的可行性。方法：观测35具经甲醛固定的尸体标本上胸椎（T1-4）椎体宽（a）／胸骨柄最窄处宽（b）（a／b）；在50例脊柱颈胸段MRI片上，测量T4椎体下缘在胸骨柄上水平投影点至颈静脉切迹中点的距离（C）／胸骨柄长（d）（c／d）。尸体标本上模拟手术入路操作。结果：a／b均值为78％±7．9％，c／d均值为72％±14．7％，a／b、c／d均〈1。经胸骨柄“U”形开窗可显露T4椎体，尸体标本上模拟手术操作，能在直视下完成T1及以上椎体的手术操作。结论：经胸骨柄“U”形开窗可显露T4椎体并能充分满足T3及以上椎体前路手术操作要求。Objective：To prove the feasibility of ＂U＂ fenestration in the sternal manubrium to expose upper thoracic vertebra. Methods： To survey the widths of upper thoracic vertebras （T1-4 ）/ the most narrow width of manubrium sterni （a/b） on 35 cases of corpse fixed by formalin. To measure and calculate the lengths from the level projection point of lower border of T4 in the sternal manubrium to the midpoint of jugular notch/ the lengths of sternal manubrium （c/d） on 50 films of MRI. The sham operations through operative approaches were practised on cadaveric samples. Results：The means of a/b and c/d were 78% ±7.9% and 72% ± 14. 7%, respectively. Furthermore, the values of a/b and c/d were less than 1. By the ＂ U＂ fenestration in sternal manubrium could approach to T4. T3 and its upper vertebrae could be intuitively disclosed when the sham operations were carried out on the samples. Conclusion： The＂U＂ fenestration in manubrium sterni could expose T4 vertebra and sufficiently satisfied the requirement of anterior operations for T3 and its upper vertebrae.

关 键 词：胸骨柄 上胸椎 手术入路 解剖 

分 类 号：R687.3[医药卫生—骨科学]