心冠状窦的年龄解剖学研究

The anatomical study of different-aged human coronary sinus

目的 为临床应用提供心冠状窦的年龄解剖学资料。方法 30例成人心脏和 180例分成 6个年龄组的儿童心脏 ,观察冠状窦口的朝向和瓣膜形态 ,测量窦口直径 ,并将其与心最大宽径作直线回归分析。结果 冠状窦口全部朝向右前上方 ,窦口平面与水平面之夹角为 49°± 6°。冠状窦瓣缺失或不明显者占 15 .2 % ;瓣膜形状以半月形为多见 (6 0 .5 % ) ,其他呈袋状、网状、筛状或条索状者占 2 4.3%。冠状窦口直径与心脏最大宽径呈正相关 ,直线回归方程成人为 ^Y =4.2 5 +0 .0 7X ,儿童为 ^Y =1.0 3 +0 .0 9X。 结论 根据冠状窦口的朝向和冠状窦瓣的观察结果 ,利用所提供的回归方程和心脏最大宽径可推算出冠状窦口的直径 ,为心导管型号的选择及手术入路提供解剖学资料 ,并为临床心导管术中部分难或无法进入冠状窦提供形态学资料。

Objective To provide data about morphometry and age anatomy for the clinic application of the coronary sinus.Methods All 210 cadavers, among which 30 adults and 180 children are divided into seven groups according to age and height, are observed. The direction of the opening and shape of the valves of the coronary sinus are observed and measured. Regression analysis is taken on the relationship between the diameter of the openings and maximum width of heart.Results All the coronary sinus openings were in the anterior superior right position. The angle between the plane of the opening and the horizontal plane was 49°±6°. Lacking valve was 15.2% in the total. More semilunar flap can be found in the shape of the valves (60.2%). The valves look like bag, reticularis, ethmoidale and funiculus, which covers 24.3% of the total. There is positive correlation between diameter of the openings and maximum width of the heart. The linear regression equation of the adult was =4.25+0.07X, and the children =1.03+0.09X.Conclusion According to the diameter of openings based on the linear regression equation and maximum width of heart, it can provide data of morphometry for the choice of cardiac catheter and the approach of operation. The results show that it is difficulty for the cardiac catheter in parts of patients to cross the openings during cardiac catheterization.