成人食管胃连接部的解剖学观测

Anatomical observation of the conjunct region between esophagus and stomach

目的 :观测食管胃连接部的形态、结构及食管壁肌层的形态和厚度的变化。方法 :在 30具成人尸体上观察食管下端的形态、结构 ,并对His角 ,Z线及食管各段肌层的厚度进行了测量。结果 :His角的角度为71 4 0°± 12 18°;Z线距贲门口平面的距离为 11 87mm± 1 6 5mm ;食管上 1/ 3段、中 1/ 3段、距离贲门口 5、 4、3、 2、 1mm及贲门口平面处管壁肌层的厚度分别为 2 11mm± 0 4 2mm ,2 36mm± 0 5 0mm ,2 5 9mm±0 88mm ,3 13mm± 0 72mm ,3 2 1mm± 0 89mm ,3 11mm± 0 6 7mm ,3 0 4mm± 0 6 2mm和 2 94mm±0 6 5mm。结论 :食管下段距贲门口平面 4cm的一段食管管壁的肌层比上、中段明显增厚 (P <0 0 1)。这一段肌层增厚区域的范围与临床上所观测到的食管下端管腔内存在着一段静止高压带 (即食管下括约肌 )的位置相符。

Objective:To observe the shape,structure and thickness of esophageal wall of the conjunct region between esophagus and stomach.Methods:The shape and structure of the lower esophagus,angle of His,Z line,gastric sling fiber,clasp fibers and the thickness of different level of esophageal wall were observed on 30 adult cadavers.Results:The angle of His was 71 40°±12 18°;the distance from the orifice of cardia to Z line was 11 87mm±1 65mm;the thickness of esophageal wall of the upper 1/3,middle 1/3,and 5,4,3,2,1mm from the orifice of cardia and cardiac orifice level was 2 11mm±0 42mm,2 36mm±0 50mm,2 59mm±0 88mm,3 13mm±0 72mm,3 21mm±0 89mm,3 11mm±0 67mm,3 04mm±0 62mm and 2 94mm±0 65mm respectively.Conclusion:It is quite obvious that the thickness of lower esophageal wall within 4cm from the orifice of cardia was thicker than that in upper and middle parts.The extent of thickened esophageal wall was in agreement with the site where there was an intraluminal resting high pressure zone of lower esophagus(LES) discovered in clinical observation.