经左听诊三角胸膜外动脉导管结扎术的应用解剖  

Applied anatomy of ligation of patent arterial duct on extrapleura through left triangle of auscultatory

作　　者：牛松青[1] 张建业[1] 鞠加光[1] 吴巧[1] 李剑锋[1] 

机构地区：[1]第四军医大学吉林军医学院解剖学教研室,吉林吉林132013

出　　处：《中国临床解剖学杂志》2003年第4期339-340,共2页Chinese Journal of Clinical Anatomy

摘　　要：目的 :为从左听诊三角入路经胸膜外进行动脉导管结扎术提供解剖学基础。方法 :在 3 0例小儿固定尸体上模拟经左听诊三角入路手术 ,对与动脉导管结扎术有关的肌肉、胸膜、神经及血管进行了解剖学观测。结果 :经左侧听诊三角入路第 4肋间隙切口处距交感干 ( 2 .74± 0 .41)cm ,距胸主动脉 ( 3 .3 8±0 .61)cm ,距左肺根上缘 ( 3 .5 0± 0 .5 7)cm ,距动脉导管 ( 4 .2 5± 0 .5 7)cm ,推肺向前约 ( 2 .10± 0 .5 0 )cm。结论 :手术中应注意胸膜的剥离、肋间隙切口的大小及与其密切相关的神经和血管。以听诊三角为标志 ,经第 4肋间隙入路胸膜外行动脉导管结扎术安全可行。Objective: To provide anatomical basis for the ligation of the patent arterial duct on the extrapleura through the left traingle of auscultatory. Methods: The muscles, pleura, nerves and blood vessels concerned with the ligation of patent arterial duct on extrapleura through left triangle of auscultatory were dissected and observed in 30 infant specimens by imitating operative approaches. Results: To employ the left auscultatory triangle approach, the average distance from the cut point of the fourth intercostal space to the sympathetic trunk, thoracic aorta, left upper edge of the root of lung and arterial duct was 2.74±0.41 cm, 3.38±0.61 cm, 3.50±0.57 cm, 4.25±0.57 cm, 2.10±0.05 cm respectively. Conclusions: The present study showed that it is suitable for the ligation of the patent arterial duct of the extrapleura through the fourth intercostals space on the mark of the left triangle of auscultatory .During the operation, correct distinguishment of anatomical layers and accurate judgement of ligation point are important.

关 键 词：听诊三角 胸膜外 动脉导管 结扎术 

分 类 号：R322.121[医药卫生—人体解剖和组织胚胎学]