正常人体二尖瓣的形态学观测

Anatomic investigation of valva mitralis

目的:研究左房室口周长、左房室口面积、二尖瓣前、后叶的面积及各自附着缘长度等,并阐明左房室口与瓣叶之间的关系,为心脏瓣膜病手术修补与移植等提供参考资料。方法:取正常人体防腐心脏24个。在左心房近左房室口处近似垂直心脏长轴的平面将左房室口以上的左心房结构切除,测量左房室口的周长与面积。在心脏二尖瓣后内侧联合处沿心脏的长轴将心脏剖开,并切断部分腱索。将心脏展开,分别测量二尖瓣前、后叶的面积及各自附着缘的长度。结果:前瓣的面积[(6.487±1.238)cm2]大于后瓣的面积[(4.036±1.658)cm2],左房室口面积为(5.363±1.461)cm2,前瓣的面积大于左房室口面积,后瓣的面积小于左房室口的面积。左房室口的面积约占前后瓣总面积的0.524±0.121。左房室口的周长约在(8.175±2.116)cm之间,前瓣附着缘的长度[(4.474±1.169)cm]大于后瓣附着缘的长度[(3.701±0.954)cm]。结论:二尖瓣前叶面积大于左房室口面积和后瓣面积,具有一定的形态学储备和潜力,在二尖瓣的修补与移植中有一定的临床价值。

Objective To observe the configuration and traits of valva mitralis. The circumference of the margin of left atrioventricular orifice, and the attached part of cuspis anterior and cuspis posterior were measured; the area of the orifice, cuspis anterior and cuspis posterior were calculated, in order to clarify the relationships of them and provide data for vavular disease repair operation and vavle transplantation. Methods The measurement and macroscopic investigation were performed on the hearts from 24 embalmed cadaver specimens. The most part of the left atrium that was above the orifice were removed. Then the circumference and area of the left atrioventricular orifice were measured. The left ventricle along the long axis of heart from the posteriomedial commissural part was dissected. The chordae tendinease was cut off. The ventricle was opened and made plain. Then the length of attached margins and area of the valves were measured. Results The area of the cuspis anterior was （6. 487 ± 1. 238） cmz while it was （5. 363±1. 461） cm^2 of the orifice and （4. 036±1. 658） cm^2 of the cuspis posterior. The area of the orifice was about 0. 524±0. 121 of that of the total valves. The circumference of the orifice was （8. 175±2. 116） cm, and the margin of the attached part of cuspid anterior was （4. 474±1. 169） cm while it was （3. 701±0. 954） cm of the cuspis. Conclusion The data accumulated anatomically is better than that of common radiology and ultrasonic cardiography indirectly. The area of cuspis anterior is larger than that of the cuspis posterior, and the valva mitralis has morphologic potential and reservation. It has more clinical significance in vavle repair surgery and valve transplantation.