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目的解剖分离人体心脏房室结和房室环的结构,阐述它们的形态特征及相互关系。方法通过体视显微镜解剖12例人体心脏的房室结、主动脉后结及房室环,再进行组织学观察,并绘图演示它们的结构关系。结果在二尖瓣环和三尖瓣环靠近冠状窦前缘处分别暴露了左、右房室环(12/12),直径分别为(0.69±0.12)mm、(0.78±0.13)mm。此处的左、右房室环穿行在房室隔内的心房肌与心室肌之间的间隙中,向房室结方向延伸。主动脉后结在主动脉根后方的房间隔中被探查到(7/9),它的后上方的房间隔间隙中有肌纤维与其相连,它的前下方分出左、右房室环,并且此处的左环比右环粗。在中心纤维体后方的心内膜下的深部,主动脉后结与房室结之间有直接的心肌组织连接通路,这条通路有别于另两条通路(左、右房室环)。结论主动脉后结和房室环可通过体视显微镜解剖暴露,主动脉后结与房室结之间有3条通路。
Objective To dissect and separate the structures of atrioventricular and atrioventricular rings in human heart and to elucidate their morphological characteristics and their interrelations. Methods 12 cases of human heart atrioventricular node, aortic posterior node and atrioventricular ring were dissected by stereomicroscope. Then the histological observation was performed and the structure relationship was demonstrated by plotting. Results Left and right atrioventricular rings (12/12) were exposed near the anterior border of the coronary sinus in the mitral annulus and tricuspid annulus with diameters of (0.69 ± 0.12) mm and (0.78 ± 0.13) mm, respectively. Here the left and right atrioventricular ring perforation of the atrial and ventricular muscles in the atrioventricular space between the gap, extending to the direction of the AV node. The aortic posterior node is detected in the atrial septum posterior to the aortic root (7/9), with the muscle fibers attached to the atrial septum above the posterior aorta, with the anterior and posterior branches of the left and right atrioventricular rings, and The left ring is thicker than the right ring here. Deep in the subendocardial space behind the central fibrous body, there is a direct myocardial connection between the posterior aorta and atrioventricular node, which is distinct from the other two pathways (left and right atrioventricular rings). Conclusion Aortic posterior node and atrioventricular ring can be anatomized by stereomicroscope. There are 3 pathways between the posterior aorta and atrioventricular node.