Marshall静脉化学消融治疗持续性房颤的临床解剖  

Clinical anatomy of vein of Marshall chemical ablation for persistent atrial fibrillation

作　　者：崔贝贝 乔梁 黄志伟 郭晓丹 顾赛男 Cui Beibei;Qiao Liang;Huang Zhiwei;Guo Xiaodan;Gu Sainan(Department of Cardiovascular Medicine,The First Affiliated Hospital,Naval Medical University,Shanghai 200433,China;Department of Anatomy,Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院心血管内科,上海200433 [2]海军军医大学人体解剖学教研室,上海200433

出　　处：《解剖学杂志》2024年第4期299-302,共4页Chinese Journal of Anatomy

摘　　要：目的:探讨经Marshall静脉(VOM)化学消融治疗持续性房颤的解剖学基础。方法:选取10%甲醛固定成人心标本,剖查VOM,利用游标卡尺测量其长度、末端外径、开口距冠状窦口的长度以及汇入冠状窦处外径及与冠状窦的夹角;测量冠状窦长度及其窦口纵、横径。结果:VOM长度(32.53±11.72)mm,末端外径(1.82±0.50)mm,可通过5F JR4导引管的比例为60.71%;VOM开口距离冠状窦口的长度(36.21±11.57)mm;VOM汇入冠状窦处外径(7.42±2.09)mm;VOM与冠状窦所成夹角(43.98±15.75)°;冠状窦长度(61.84±15.37)mm,窦口纵径(12.61±3.15)mm、横径(8.07±2.25)mm。冠状窦口的纵径分别与其横径、冠状窦VOM汇入处的外径比较,差异具有统计学意义。冠状窦、VOM开口距离冠状窦口的长度比较,差异具有统计学意义。其余各项目在不同性别之间相互比较差异均无统计学意义。结论:从大体解剖水平测量VOM的长度、外径,为更好开展VOM化学消融术治疗持续性房颤提供形态学参考。Objective:To explore the anatomical basis of vein of Marshall(VOM)chemical ablation for the treatment of persistent atrial fibrillation.Methods:Thirty-four 10%formalin-fixed adult heart specimens were selected and the VOM was dissected and statistically analyzed.Using a vernier caliper,the VOM length,the outer diameter of its end,the distance from the VOM opening to the orifice of coronary sinus,and the outer diameter of the coronary sinus and the outer diameter of the coronary sinus at the point where the VOM converges were measured.The length of the coronary sinus and its longitudinal and transverse diameters,as well as the angle between the VOM and the coronary sinus,were measured.Results:The VOM length was(32.53±11.72)mm.The outer diameter of the end of VOM was(1.82±0.50)mm,and the proportion of cases that could be accessed using a 5F JR4 guiding catheter was 60.71%.The distance from the VOM opening to the orifice of the coronary sinus was(36.21±11.57)mm.The outer diameter at the point where the VOM converges with the coronary sinus was(7.42±2.09)mm.The angle between the VOM and the coronary sinus was(43.98±15.75)°.The length of the coronary sinus was(61.84±15.37)mm,with a longitudinal diameter of the sinus orifice being(12.61±3.15)mm,and a transverse diameter of(8.07±2.25)mm.The differences between the longitudinal diameter and the transverse diameter of the coronary sinus orifice,as well as the outer diameter at the point where the VOM converges with the coronary sinus,were statistically significant.The differences between the lengths of the coronary sinus and the distance from the VOM opening to the coronary sinus orifice were also statistically significant.The other items showed no statistically significant differences in comparison between genders.Conclusion:This study measured the length and outer diameter of VOM at a gross anatomical level,providing morphological references for the application of VOM chemical ablation therapy in treating persistent atrial fib rillation.

关 键 词：Marshall静脉 冠状窦 房颤 化学消融 临床解剖 

分 类 号：R321.1[医药卫生—人体解剖和组织胚胎学]