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目的:通过对心室肌的大体解剖与组织学切片显示心室肌纤维的层次走向,比较心肌传统概念与心肌带理论的差异。方法:(1)应用大体解剖、组织切片HE染色、虚拟切片扫描方法显示心室肌的纤维走向及层次构造。(2)将防腐固定后的成人正常心脏顺心肌纤维方向分层解剖心肌,使之展开成带,验证心肌带理论。结果:将防腐固定的成人正常心脏经改良的解剖方法解剖,可解剖出一条完整的心肌带,分为2个环,4个段。心肌带呈螺旋走向。用大体解剖与组织切片HE染色、虚拟切片扫描显示右心室肌起始于纤维三角为一条单层肌肉带,左心室肌分为三层肌纤维起始于纤维三角与纤维环,肌纤维从纤维三角与纤维环持续由外向内转变呈现为一种交错结构,纵行的浅层心肌纤维在心尖以90°的角返回心底方向,构成深层心室肌形成肉柱,部分心肌纤维斜、横行构成中层心室肌。三者在心尖呈现出一种螺旋形结构。应用虚拟切片扫描技术能完整、清楚地显示心室肌某一切面的结构走向。结论:心肌传统理论与心肌带理论并未完全冲突,心肌带理论的降段、左室断、升段与传统理论的浅、中、深三层相对应。
OBJECTIVE: To compare the level of ventricular myofibers with the general anatomy and histological sections of ventricular myocytes, and to compare the differences between the traditional concept of myocardial function and the theory of myocardial band. Methods: (1) Gross anatomy, histological sections HE staining and virtual section scanning method were used to show the direction and structure of ventricular myocytes. (2) The antiseptic immobilized adult normal heart along the myocardial fibers stratified dissection of the myocardium, to expand into a band, verify the theory of myocardial band. Results: Anatomically fixed adult normal heart anatomical anatomy improved anatomy, can be dissected into a complete myocardial zone, divided into 2 rings, 4 segments. Myocardial band spiral. With gross anatomy and tissue sections HE staining, virtual section scan showed that right ventricular muscle began in the fibrous triangle as a monolayer muscle, left ventricular muscle is divided into three layers of muscle fibers beginning in the trigone and annulus fibrosis, Fibrous ring continued to transform from outside to inside as a staggered structure, longitudinal shallow myocardial fibers in the apical angle of 90 ° to return to the bottom of the heart, forming deep ventricular muscle formation of column, part of the myocardial fiber oblique, transverse formation of the middle ventricular muscle . The three showed a spiral structure at the apex. Application of virtual slice scanning technology can be a complete and clear display of the structure of a section of the ventricular myocardium. Conclusion: The traditional theory of myocardial and myocardial band theory does not completely conflict. The lower segment of myocardial band theory, the left ventricular break and the rising segment correspond to the shallow, middle and deep levels of traditional theory.