目的 通过体视显微镜和组织学方法检查新鲜猪心房室传导轴,观察其形态特征。 方法 采用30例新鲜猪心进行实验,在体视显微镜下进行房室传导轴的解剖探查,观察其形态并测量相关解剖学数据,再通过HE、Masson染色等组织学技术进行形态观察和分析。 结果 成功地检查猪心房室传导轴(22/30),发现左束支近端呈束状分布,远端呈喇叭口型散开(22例);猪心His 束、左束支、右束支的被膜相对较厚,肉眼上容易识别;房室束宽度为(1.58±0.75)mm,房室束长度为(17.56±7.79)mm,左束支近端宽度为(2.40±1.11)mm,左束支与房室束的夹角为(114.46±13.06)°。 结论 猪心房室束、左束支、右束支的位置及形态可能与人及其他动物略不同。
Abstract
Objective To observe the morphological characteristics of the atrioventricular conduction axis in fresh porcine heart by the microdissection and histological methods. Methods The anatomical data of the porcine cardiac atrioventricular conduction axis was observed, explored and measured by dissecting 30 cases of fresh porcine hearts under stereomicroscope, and their histological data were observed and analyzed by the conventional HE and Masson's staining techniques. Results The atrioventricular conduction axis was successfully detected in 22 of 30 porcine hearts, and it was found that the proximal portion of left bundle branch was arranged in fascicular, and the distal portion was flared. The capsules of his bundle, left bundle branch, and right bundle branch of porcine heart were relatively thick and easy to identify with the naked eye. The width of the atrioventricular bundle (AVB), the length of AVB, the proximal width of the left bundle branch were (1.58±0.75) mm, (17.56±7.79) mm, (2.40±1.11) mm, respectively, and the angle between the left bundle branch and the AV bundle was (114.46±13.06)°. Conclusions The position and morphological feature of AVB, left bundle branch and right bundle branch in pigs may be slightly different from other animals.
关键词
  /
心传导系统 /
  /
  /
体视显微镜 /
  /
  /
猪心 /
  /
  /
解剖学
Key words
Cardiac conduction system /
  /
  /
Stereomicroscope /
  /
  /
  /
Porcine heart /
  /
  /
  /
Anatomy
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Park D, Fishman G. Development and Function of the Cardiac Conduction System in Health and Disease[J]. J Cardiovasc Dev Dis,, 2017,4(2):7. DOI: 10.3390/jcdd4020007.
[2] Gomez-Torres FA, Sebastian R, Ruiz-Sauri A. Morphometry and comparative histology of sinus and atrioventricular nodes in humans and pigs and their relevance in the prevention of nodal arrhythmias[J]. Res Vet Sci, 2020, 128:275-285. DOI: 10.1016/j.rvsc.2019.12.008.
[3] 金立军,黄从新,杨波,等. 家兔界嵴组织电生理特征及意义[J]. 中华心血管病杂志,2004,32(8):68-71. DOI: 10.3760/j:issn:0253-3758. 2004. 08.017.
[4] 李朝旭,段德勇,崔燕. 牦牛心室普肯耶纤维的分布和结构特点[J]. 解剖学报,2013,44(1):79-84. DOI: 10.3969/j.issn.0529-1356. 2013. 01.015.
[5] 娄阳云,陈启云,施瑶瑶,等. 体视显微镜下检查成人心房室传导轴[J]. 解剖学杂志,2016,39(3):285-289. DOI: 10.3969/j.issn.1001-1633. 2016.03.007.
[6] 竞花兰,陈玉川,欧桂生. 心传导系统取材及组织形态观察的实验研究[J]. 中国法医学杂志,1996, 11(3):142-145. DOI: 10. 13618 /j . issn. 1001 -5728. 1996. 03. 006.
[7] 蒋丽梦,戴振宇,苏蓝. 损伤电流在不同类型心脏起搏中的临床价值[J]. 中国心脏起搏与心电生理杂志, 2021, 35(3):201-205. DOI: 10.13333/j.cnki.cjcpe.2021.03.002.
[8] 雷想,刘世栋,方涛,等. 经导管主动脉瓣置换术对高龄主动脉瓣狭窄患者临床疗效的系统评价与Meta分析[J]. 中国胸心血管外科临床杂志, 2020, 27(12):1446-1453. DOI: 10.7507/1007-4848.202002029.
[9] 李杰,魏廷举,刘东海,等. 三尖瓣置换术的临床分析[J]. 中南大学学报(医学版),2016,41(1):78-82. DOI: 10.11817/j.issn.1672-7347. 2016. 01.012.
[10] 戴晗怡,朱齐丰,刘先宝. 经导管主动脉瓣置换术后传导阻滞的研究现状[J]. 华西医学, 2021,36(9):1167-1171. DOI: 10.7507/1002-0179. 202107266.
[11] 蔡迟,王靖,楚建民,等. 透壁消融指数指导下高功率射频消融对离体猪心的损伤效应[J]. 中国心血管病研究, 2021,19(5):454-458. DOI: 10.3969/j.issn.1672-5301.2021.05.014.
基金
浙江省医药卫生科技项目(2020KY108);浙江省教育厅大学生创新训练项目(S202113023096)