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目的 :为经皮穿刺胸腺介入治疗重症肌无力提供应用解剖基础。方法 :童尸 15具 (男 12 ,女 3 )解剖观测胸腺的形态、血供和毗邻关系以及胸骨的前突角度。结果 :胸腺左叶和右叶长、宽、厚度分别为 :60 .7、16.7、5 .5mm和 80 .3、18.6、4.9mm ,胸腺上极伸至颈部的占 93 % ( 14例 ) ,左叶上极伸至颈部的长为 2 9.5mm ;右叶长度为 2 5 .1mm。胸腺上极与甲状腺下极的关系为 :左侧两者相距平均为 2 1.5mm ;右侧相距为 2 3 .8mm。胸腺在左头臂静脉的前面长度 :左叶为 14 .4mm ,右叶为 13 .7mm。胸骨前突的角度为10 .9°。结论 :经皮穿刺胸腺时为防止伤及左头臂静脉、上腔静脉以及胸膜腔 ,在颈部可在第 3～ 4气管软骨环 (甲状腺的峡部 )的下方进针 ;在胸部 ,沿胸骨后方上翘 10°左右的角度穿入胸腺 ,距正中线左右不超过 2 0mm处进针 ,穿刺深度左侧 40mm ,右侧 5 0mm为宜。
Objective: To provide anatomical basis for the interventional treatment of myasthenia gravis by percutaneous thrombus. Methods: 15 children (male 12, female 3) anatomical observation of thymus morphology, blood supply and the adjacent relationship and the sternum protrusion angle. Results: The length, width and thickness of the left and right thymus were 60.7, 16.7, 5.5mm and 80.3, 18.6 and 4.9mm, respectively, and 93% of the thymus extended to the neck (14 cases) , The length of the left lobe to the neck is 2 9.5 mm; the length of the right lobe is 25.1 mm. The relationship between the upper thymus pole and the lower thyroid pole is: the distance between them on the left is 2 1.5mm on the average; and the distance on the right is 2 3 .8mm. The length of the thymus in front of the left brachiocephalic vein is 14.4 mm for the left lobe and 13.7 mm for the right lobe. Sternal protrusion angle of 10.9 °. CONCLUSIONS: Percutaneous puncture of the thymus to prevent injury to the left vena cava, superior vena cava, and pleural cavity can occur at the neck below the 3rd to 4th tracheal cartilage rings (isthmus of the thyroid gland); on the chest, The rear up 10 ° angle through the thymus, from the midline not more than 20mm into the needle, puncture depth left 40mm, right 50mm appropriate.