心肌带解剖的新方法

New Method Applied to Dissection of Myocardial Band

目的解决心肌带解剖中甲醛固定过的心脏无法用于研究的问题。方法成年猪心20个,成年羊心20个,按心脏处理的方法不同分为3组,组1:不经福尔马林处理的新鲜猪心(n=10)和羊心(n=10),以Torrent-Guasp方法进行解剖;组2:经福尔马林固定过的猪心(n=5)和羊心(n=5),以Torrent-Guasp方法进行解剖;组3:经福尔马林固定过的猪心(n=5)和羊心(n=5),以新方法进行解剖。结果组1解剖过程顺利,所有心脏均解剖出基底环和心尖环,展开成带状。组2的心脏解剖困难,表现为纤维组织坚韧,游离肺动脉非常困难;徒手无法松解左、右纤维三角,肺动脉和主动脉根部的游离非常困难;心肌纤维坚硬、质脆,解剖时容易断离成碎块,无法沿纤维走行方向剥离。组3心脏解剖过程顺利,所有心脏均能按照心肌纤维的自然走行方向解剖出基底环和心尖环,最终展开成带状,心肌纤维走行方向清楚,心尖环升段和降段纤维之间的交叉角度显示清楚。结论采用Torrent-Guasp的方法顺利完成所有新鲜心脏的心肌带解剖,但无法对经福尔马林固定过的心脏进行解剖;运用改进的新方法,对福尔马林固定过的心脏均顺利完成心肌带的解剖。本研究提出的新解剖方法是研究经福尔马林固定过的心脏心肌带结构的可行方法。

Objective To solve the problem that myocardial band of stale hearts treated by formaldehyde cann＇t be used for research study. Methods Twenty sheep＇s hearts and 20 pig＇s hearts were randomly distributed to 3 groups, group 1： fresh pig＇s hearts （n = 10） and fresh sheep＇s hearts （n = 10） were dissected by Torrent-Guasp＇s method; group 2： pig＇s hearts （n = 5） and sheep＇s hearts （n= 5） treated by formaldehyde were dissected by Torrent- Guasp＇s method ; group 3： pig＇s hearts （n = 5） and sheep＇s hearts （n = 5） treated by formaldehyde were dissected by new method. Results All samples in group 1 were successfully unrolled to a myocardial band composed of basal loop and apical loop. The dissecting of samples in group 2 were difficult. The root of pulmonary artery and ascending aorta failed to be unfolded because fibrous tissue was tough, right and left fibrous trigone were too firm to be solved by hand. Cardiac muscle fibers couldn＇t be stripped along myofibrillar trajectory since they were prone to break because of their friability. On the other hand, being dissected along nature myofibrillar trajectory, all samples in group 3 were successfully unrolled to a myocardial band composed of basal loop and apical loop. Furthermore, myofibrillar trajectory was clear and the exposure of crossing angle between apical ascending segment and descending segment was ideal. Conclusion With Torrent-Guasp＇s method, the dissection of myocardial band of hearts was successful in fresh heart, but not in stale heart. On the other hand, with new method, the dissection of myocardial band of hearts was achieved in stale heart group. Our method in this research is a reliable way on dissection of myocardial band in stale hearts treated by formaldehyde.