侧胸部小切口的应用解剖  

Applied anatomy of the small incision in thoracotomy

作　　者：张晓明[1] 应勖 朱晞 袁张根 胡伟恩[2] 李浒[2] 毛宝根[2] 

机构地区：[1]浙江大学医学院解剖学教研室 [2]杭州市第一人民医院胸外科,浙江杭州310031

出　　处：《中国临床解剖学杂志》2001年第4期314-315,共2页Chinese Journal of Clinical Anatomy

基　　金：杭州市卫生局科研基金资助项目 (0 0B0 0 3)

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。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 

分 类 号：R323.2[医药卫生—人体解剖和组织胚胎学]