右心耳壁厚及梳状肌间凹深度测定对起搏电极定位的意义

目的 通过测量右心耳壁厚度及梳状肌间凹深度，为临床心房起搏电极的定位提供解剖学基础。方法 将50具经福尔马林处理尸体的右心耳，按水平距离和垂直距离分成内上、外上、内中、外中、内下、外下6个区域，测量各区的心肌壁厚度及梳状肌间凹。另用5具尸体于福尔马林处理前后行上述数据测定，以获得心壁厚度和梳状肌间凹深度的增减百分率，并对50具处理尸体的测值作校正。结果 50具经福尔马林处理尸体和5具未经福尔马林处理尸体的心耳壁厚度和梳状肌间凹的深度作比较，无统计学差异（P〉0．05）；但女性右心耳较男性小（P〈0．05）。结论 经福尔马林处理尸体的测值校正后能反映新鲜尸体的情况。右心耳内上、外上区域（梳状肌间凹的深度〉6mill）适宜翼状电极定位。内上、外上及内中区域（心耳壁厚度≥2mm）用螺旋电极定位是安全的；女性患者电极定位要注意安全。

Significance of Right Auricular Wall Thickness and Interpectinate Foveae Depth in Positioning Pacing Electrodes

Objective To provide anatomical basis of positioning pacing electrodes by measuring right auricular wall thickness and interpectinate foveae depth. Methods For 50 formalin-treated adult corpses,the right auricle was divided into 6 areas,including top inside,top outside,middle inside,middle outside,bottom inside and bottom outside.The wall thickness and the interpectinate foveae depth in each region were determined.These measurements were also performed in 5 adult corpses before and after formalin treatment,and the coefficient was used to correct for the values obtained in 50 formalin-treated adult corpses. Results In 50 formalin-treated and 5 untreated adult corpses, the average right auricular wall thickness and the average interpectinate foveae depth had no significant difference((P>0.05).) Female's right auricle was smaller than male's one(P<0.05). Conclusion Measurement of right auricular anatomy suggests that both top inside and outside areas where the interpectinate foveae depth is greater than 6 mm may be suitable for aliform electrode positioning,whereas,top inside and outside,middle inside areas where wall thickness is greater than 2 mm may be safely used helix electrode positioning.Female should be careful during position of both pacing electrodes.