肋软骨连结临床应用解剖研究

Clinical anatomy on costochondral junction

目的 :了解肋软骨连结形态特点 ,为临床选择切除肋软骨的部位提供依据。方法 :对 2 9具儿童尸体标本进行肋软骨测量 ,光镜下观察肋软骨连结组织学特点 ,并对肋软骨折断后进行断端组织学观察。结果 :左侧第 1～ 8肋软骨长度分别为 2 .9、3.0、3.5、4.2、5.0、6 .5、8.4、1 0 .9cm ,右侧者与左侧者相近。第 5～ 7肋增殖区加肥大区厚度相近 ,平均为 0 .43mm。折断肋软骨后 ,髓腔骨松质、Ranvier区和肥大区明确受损。结论 :胸骨上举术应改牵拉折断为锐性切断肋软骨 ,并至少保留 0 .5cm肋软骨。

Objective: To provide anatomic basis for the position selection of costochondrectomy.Methods: The costochondral lengths were measured on 29 children bodies and the histological characteristics of costochondral joints were observed by light microscopy.Results:The mean lengths of the lst to 8th left costal cartilage were 2.9, 3.0, 3.5, 4.2, 5.0, 6.5, 8.4 and 10.9 cm respectively.Values on the right were similar to those on the left.The mean depths of proliferation zone plus hypertrophic zone of the 5th to 7th costochondral joints were 4.3 mm.The definitely damaged portions of the fracture were cancellous bone, Ranvier's groove and hypertrophic zone.Conclusions:In sternum elevation, the costal cartilage should be sharply cut instead of being broken and at least 0.5 cm of the costal cartilage should be reserved.