用于优化胸腔镜下牵拉食管的磁锚定装置的胸廓参数分析

目的:为优化胸腔镜下牵拉食管的磁锚定装置提供理论依据。方法:测量我院105例患者（男71、女34）在2个肋间（第4肋、第6肋）与右胸4条胸部标志线（锁骨中线、腋前线、腋中线、腋后线）交点处的胸壁厚度，不同BMI水平下右胸的胸壁厚度，第4肋和第6肋平面上的胸廓内径线（前后径、左右径）。食管至壁层胸膜间的最大距离、人体胸廓前后径的后半部分与左右径的右半部分三者可形成一个直角三角形，通过直角三角形的勾股定理，可计算食管至壁层胸膜间的最大距离，其与胸壁厚度之和即为导致磁锚定装置磁力衰减的最大距离。结果:不同性别、不同肋间、不同胸部标志线、不同BMI水平下的胸壁厚度如下:男性胸壁厚度范围在第4肋为(19.43±4.57~61.6±9.63)mm，第6肋为(16.91±3.69~48.19±8.3)mm；女性胸壁厚度范围在第4肋为(25.74±7.16~58.41±10.22)mm，第6肋为(19.76±6.6~47.07±7.99)mm。不同性别、不同肋间处的胸廓内径线如下:男性胸廓前后径范围在第4肋为(103.21±14.99)mm，第6肋为(123.73±15.83)mm；女性胸廓前后径范围在第4肋为(88.08±12.74)mm，第6肋为(105.67±12.9)mm；男性胸廓左右径范围在第4肋为(230.20±19.06)mm，第6肋为(249.01±15.24)mm；女性胸廓左右径范围在第4肋为(213.88±11.19)mm，第6肋为(228.03±11.84)mm。通过所得数据可计算出在胸壁某点处引起磁锚定装置磁力衰减的距离。结论:测量所得的胸壁厚度及胸廓内径线参数范围，可为应用于胸腔镜手术中牵拉食管的磁锚定装置的参数优化提供理论依据。

Thoracic parameter analysis for optimizing the magnetic anchoring device used to pull the esophagus in thoracoscopic esophagectomy

Objective:To provide a theoretical basis for optimizing the magnetic anchoring device used to pull the esophagus in thoracoscopic esophagectomy.Methods:It were measured that the chest wall thicknesses at the point of intersection of two ribs (the fourth rib and sixth rib) and four chest marking lines (the mid-clavicular line,the anterior axillary line,the mid-axillary line,and the posterior axillary line) of 105 patients (male 71 and female 34) on the right chest in our hospital.The chest wall thicknesses on the right chest of different BMI levels were also measured.The inner diameters in thorax of the fourth and sixth rib levels (anteroposterior diameter,cross diameter) were measured.The right triangle consists of a hypotenuse and two right sides,the length of whom is the maximum distance from esophagus to the parietal pleura,the posterior part of the anteroposterior diameter,and the right part of the cross diameter,respectively.The hypotenuse's length of the right triangle equal to the maximum distance from esophagus to the parietal pleura,is calculated by the pythagorean theorem.The sum of the hypotenuse's length with the chest wall thickness is the maximum distance causing the magnetic anchoring device attenuated.Results:The chest wall thicknesses of different genders,rib levels,chest marking lines and BMI levels are as follows:The chest wall thicknesses of the fourth and sixth rib of men were (19.43±4.57~61.6±9.63)mm and (16.91±3.69~48.19±8.3)mm.Those of women were (25.74±7.16~58.41±10.22)mm and (19.76±6.6~47.07±7.99)mm.The inner diameters of different genders and rib levels are as follows:The anteroposterior diameters of the fourth and sixth rib of men were (103.21±14.99)mm and (123.73±15.83)mm.Those of women were (88.08±12.74)mm and (105.67±12.9)mm.The cross diameters of the fourth and sixth rib of men were (230.20±19.06)mm and (249.01±15.24)mm.Those of women were (213.88±11.19)mm and (228.03±11.84)mm.Based on the obtained data,we calculated the distance causing the magnetic attenuation of magnetic anchoring device.Conclusion:The measured chest wall thickness and thoracic inner diameter parameters can provide a theoretical basis for optimization of the magnetic anchoring device used to pull the esophagus in thoracoscopic esophagectomy.