新生儿膈食管裂孔的应用解剖学

本文观察了50例新生儿的膈,食管孔均呈梭形矢状位,裂孔的高度92%位于第8～10胸椎前方。构成裂孔两侧缘的肌束主要来自右内侧膈脚,又根据肌束来源及位于裂孔两侧肌束情况,把食管裂孔分为五型。裂孔边缘和食管之间的间隙,以食管外侧间隙为形成食管裂孔疝的好发部位。同时,还观察到连结食管和膈之间的膈食管韧带有防止食管裂孔疝的作用。

Applied Anatomy of the Esophageal Opening of Diaphragm in Neonates

The esophageal opening of the diaphragm (EOD) was studied on 50 Chineseneonatal cadavers (male 16,female 34).The results are as follows:All of theEOD are shuttle-like and in a sagittal position.92% of the EOD are located in front of the eighth to tenth thoracic vertebra.There are five patterns accordingto the muscles that located around the EOD and the muscle origin.In 70% ofthe cases,both parts of the EOD are formed mainly by the right crus;while in20% of the cases,the right part of the EOD is formed by the left crus.Thehernia mostly happens at the lateral hiatus between the esophagus and theEOD.The phreno-esophageal ligament was found relatively apparent at the an-terior and posterior parts of the esophagus,whch may prevent the occuranceof the hernia.