中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2014年
1期
7-10
,共4页
侯前梅%田东%付茂勇%骆明炎%张娇%蓝乙峰%廖振云%谢兴国
侯前梅%田東%付茂勇%駱明炎%張嬌%藍乙峰%廖振雲%謝興國
후전매%전동%부무용%락명염%장교%람을봉%료진운%사흥국
喉返神经%食管癌%应用解剖%损伤
喉返神經%食管癌%應用解剖%損傷
후반신경%식관암%응용해부%손상
Rcurrent laryngeal nerve%Eophageal cancer%Applied anatomy%Operation damage
目的 为临床上行食管癌根治术减少喉返神经损伤提供解剖学依据.方法 40具甲醛固定的成人尸体标本,解剖观测双侧喉返神经的分支、走行、各部横径及到毗邻解剖标志的距离.结果 喉返神经在气管食管沟内的走形有垂直上行、由外下向内上斜行和不规则走形,喉返神经分支外形呈干状或袢状；喉返神经各部(起点、第1分支点、人气管食管沟点、入喉点)横径,左侧分别为(2.29±0.91) mm、(0.98 ±0.60) mm、(1.49 ±0.57) mm、(1.27 ±0.53) mm；右侧分别为(1.89±0.72)mm、(0.96 ±0.50) mm、(1.56±0.61) mm、(1.23±0.58) mm；左、右喉返神经各部分别到其毗邻解剖标志(食管纵轴、颈静脉切迹、同侧静脉角、喉结、同侧甲状软骨下角)的距离各不相同；双侧喉返神经起点分别到入喉点、锁骨下动脉起始部的距离有所差异,左、右侧喉返神经在入喉处距同侧静脉角分别为(40.17±6.58) mm和(43.11±7.06) mm.结论 了解喉返神经的解剖学特点,对避免食管癌根治术喉返神经损伤所造成的并发症有重要意义.
目的 為臨床上行食管癌根治術減少喉返神經損傷提供解剖學依據.方法 40具甲醛固定的成人尸體標本,解剖觀測雙側喉返神經的分支、走行、各部橫徑及到毗鄰解剖標誌的距離.結果 喉返神經在氣管食管溝內的走形有垂直上行、由外下嚮內上斜行和不規則走形,喉返神經分支外形呈榦狀或袢狀；喉返神經各部(起點、第1分支點、人氣管食管溝點、入喉點)橫徑,左側分彆為(2.29±0.91) mm、(0.98 ±0.60) mm、(1.49 ±0.57) mm、(1.27 ±0.53) mm；右側分彆為(1.89±0.72)mm、(0.96 ±0.50) mm、(1.56±0.61) mm、(1.23±0.58) mm；左、右喉返神經各部分彆到其毗鄰解剖標誌(食管縱軸、頸靜脈切跡、同側靜脈角、喉結、同側甲狀軟骨下角)的距離各不相同；雙側喉返神經起點分彆到入喉點、鎖骨下動脈起始部的距離有所差異,左、右側喉返神經在入喉處距同側靜脈角分彆為(40.17±6.58) mm和(43.11±7.06) mm.結論 瞭解喉返神經的解剖學特點,對避免食管癌根治術喉返神經損傷所造成的併髮癥有重要意義.
목적 위림상상행식관암근치술감소후반신경손상제공해부학의거.방법 40구갑철고정적성인시체표본,해부관측쌍측후반신경적분지、주행、각부횡경급도비린해부표지적거리.결과 후반신경재기관식관구내적주형유수직상행、유외하향내상사행화불규칙주형,후반신경분지외형정간상혹번상；후반신경각부(기점、제1분지점、인기관식관구점、입후점)횡경,좌측분별위(2.29±0.91) mm、(0.98 ±0.60) mm、(1.49 ±0.57) mm、(1.27 ±0.53) mm；우측분별위(1.89±0.72)mm、(0.96 ±0.50) mm、(1.56±0.61) mm、(1.23±0.58) mm；좌、우후반신경각부분별도기비린해부표지(식관종축、경정맥절적、동측정맥각、후결、동측갑상연골하각)적거리각불상동；쌍측후반신경기점분별도입후점、쇄골하동맥기시부적거리유소차이,좌、우측후반신경재입후처거동측정맥각분별위(40.17±6.58) mm화(43.11±7.06) mm.결론 료해후반신경적해부학특점,대피면식관암근치술후반신경손상소조성적병발증유중요의의.
Objective To provide anatomical basis for clinical esophageal cancer surgery protect the recurrent laryngeal nerve.Methods 40 formalin-fixed adult cadavers,anatomical observation of the shape of the recurrent laryngeal nerve and its branches,running way,departments and diameter of the recurrent laryngeal nerve,recurrent laryngeal nerve ministries to adjacent anatomical landmarks distance.Results (1) the recurrent laryngeal nerve (RLN) in the tracheoesophageal groove upstream vertical upward,inward from the outside on the oblique and irregular in shape,the recurrent laryngeal nerve branch shape stem-like or loop-like; (2) the RLN ministries (the starting point,The first branch point,into the tracheoesophageal groove point,into the larynx point) diameter,the left side of (2.29 ± 0.91) mm,(0.98 ± 0.60) ram,(1.49 ±0.57) mm,(1.27±0.53) mm; the right side of(1.89±0.72) mm,(0.96±0.50) mm,(1.56±0.61) mm,(1.23±0.58) mm; (3) left and right RLN ministries to adjacent anatomical landmarks (the esophageal central line,the jugular notch,the ipsilateral venous angle,the prominentia laryngea,the inferior horn of thyroid cartilage) the distance is not the same; (4) the RLN starting point to the point into the throat,the distance of the subclavian artery and have their own characteristics,point into the throat to ipsilateral venous angle left and right,respectively (40.17 ± 6.58) mm and (43.11 ±7.06)mm.Conclusion Esophageal cancer surgery should be carefully observed,and mastery of the recurrent laryngeal nerve anatomy is important to reduce iatrogenic injury and better development of the surgical treatment of esophageal cancer.
