CN115132046B - Functional anatomy inspection method for right ventricular outflow tract - Google Patents
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Abstract
本发明创新性提供了一种右心室流出道的功能解剖学检查方法，属于心脏解剖技术领域。包括打开心脏的右心室，暴露右心室流出道的间隔部，检查肺动脉瓣、右心室流出道是否完整，依次测量肺动脉各瓣长度、肺动脉瓣下缘平面周长、肺动脉瓣上缘平面周长、肺动脉瓣下缘与肺动脉瓣上缘的中间平面周长等步骤。本发明在检查与分离右心室流出道的同时，避免了对肺动脉瓣(尤其是前瓣)、三尖瓣、房室结的破坏；创立并准确记录了右心室流出道的多项功能解剖学形态指标，确定了右心室流出道的取材部位与取材方法，为右心室流出道功能解剖学、组织形态学研究提供了科学、系统的检查方法。
The invention innovatively provides a functional anatomical inspection method of the right ventricular outflow tract, which belongs to the technical field of cardiac anatomy. Including opening the right ventricle of the heart, exposing the septum of the right ventricular outflow tract, checking whether the pulmonary valve and the right ventricular outflow tract are complete, measuring the length of each valve of the pulmonary artery, the circumference of the lower edge of the pulmonary valve, the circumference of the upper edge of the pulmonary valve, Steps such as the mid-plane circumference of the lower border of the pulmonary valve and the upper border of the pulmonary valve. The invention avoids damage to the pulmonary valve (especially the anterior valve), the tricuspid valve and the atrioventricular node while checking and separating the right ventricular outflow tract; it creates and accurately records multiple functional anatomy of the right ventricular outflow tract The morphological index determines the location and method of sampling the right ventricular outflow tract, and provides a scientific and systematic inspection method for the functional anatomy and histomorphological research of the right ventricular outflow tract.
Description
技术领域technical field
本发明属于心脏解剖技术领域，尤其涉及一种右心室流出道的功能解剖学检查方法。The invention belongs to the technical field of cardiac anatomy, and in particular relates to a functional anatomical inspection method of a right ventricular outflow tract.
背景技术Background technique
右心室流出道(right ventricular outflow tract,RVOT)，是右心室向左上方的突出部分，形似倒置漏斗，或称漏斗部、动脉圆锥，以室上嵴为下界，上接肺动脉瓣，内侧为室间隔，前壁为右心室前壁。作为右心室中的特殊结构，与多种室性心律失常的发生有关，作为心律失常常见的起源点，是由其解剖三维结构与胚胎发育多因素共同决定的。Right ventricular outflow tract (right ventricular outflow tract, RVOT) is the protruding part of the right ventricle to the upper left, shaped like an inverted funnel, or called the infundibulum, conus arteriosus, with the superior ventricular crest as the lower boundary, connected to the pulmonary valve on the upper side, and the ventricle on the inner side septum, the anterior wall is the anterior wall of the right ventricle. As a special structure in the right ventricle, it is related to the occurrence of various ventricular arrhythmias. As a common origin of arrhythmia, it is determined by its anatomical three-dimensional structure and embryonic development.
针对RVOT的形态学结构检查，目前国内外多以影像学检测手段为主，包括超声心动图、CT、MRI等，检测指标包括RVOT容量、室壁运动、直径等；针对RVOT的组织学检查，目前国内外对部分致心律失常性右室心肌病、Brugada综合征患者的流出道心肌组织进行脂肪、纤维化等检查；针对RVOT的电生理检查，目前国内外采用激动标测、起搏标测、电压标测等技术检测患者心律失常发生时的起源点，予以射频消融治疗。For the morphological structure examination of RVOT, at present, imaging detection methods are mainly used at home and abroad, including echocardiography, CT, MRI, etc. The detection indicators include RVOT volume, wall motion, diameter, etc.; for the histological examination of RVOT, At present, the outflow tract myocardial tissue of some patients with arrhythmogenic right ventricular cardiomyopathy and Brugada syndrome is checked for fat and fibrosis at home and abroad; for the electrophysiological examination of RVOT, excitation mapping and pacing mapping are currently used at home and abroad , voltage mapping and other technologies to detect the origin point of the patient's arrhythmia, and perform radiofrequency ablation treatment.
已有的对RVOT的检查手段与方法，均非全面、直接检查，尤其是关于RVOT形态结构的测量仍处于初级阶段，尚未有较为深入的研究。Existing means and methods for RVOT inspection are not comprehensive and direct inspection, especially the measurement of RVOT morphology structure is still in its infancy, and there has not been more in-depth research.
发明内容Contents of the invention
有鉴于此，本发明的目的在于提供一种右心室流出道的功能解剖学检查方法，采用本发明提供的检查方法可完整、准确地记录右心室流出道的形态学指标。In view of this, the object of the present invention is to provide a method for examining the function and anatomy of the right ventricular outflow tract, which can completely and accurately record the morphological indicators of the right ventricular outflow tract.
为了实现上述发明目的，本发明提供了以下技术方案：In order to realize the above-mentioned purpose of the invention, the present invention provides the following technical solutions:
本发明提供了一种右心室流出道的检查方法，包括以下步骤：The invention provides a method for checking the right ventricular outflow tract, comprising the following steps:
1)自上而下，于肺动脉瓣前瓣与左瓣之间连接处，沿前室间沟至心尖，打开心脏的右心室，充分暴露右心室流出道的间隔部；1) From top to bottom, open the right ventricle of the heart at the connection between the anterior valve of the pulmonary valve and the left valve, along the anterior interventricular groove to the apex, and fully expose the septum of the right ventricular outflow tract;
2)检查肺动脉瓣、右心室流出道是否完整，依次测量肺动脉各瓣长度、肺动脉瓣下缘平面周长、肺动脉瓣上缘平面周长、肺动脉瓣下缘与肺动脉瓣上缘的中间平面周长、室上嵴最高点至肺动脉瓣膜下缘平面最短距离、右心室流出道的游离壁和右心室流出道的间隔部厚度；2) Check whether the pulmonary valve and the right ventricular outflow tract are complete, and measure the length of each valve of the pulmonary artery, the circumference of the lower edge of the pulmonary valve, the circumference of the upper edge of the pulmonary valve, and the circumference of the middle plane between the lower edge of the pulmonary valve and the upper edge of the pulmonary valve. , the shortest distance from the highest point of the supraventricular ridge to the lower border of the pulmonary valve, the thickness of the free wall of the right ventricular outflow tract and the septum of the right ventricular outflow tract;
由于右心室流出道的前间隔与主动脉左瓣下方左心室流出道肌性组织融合形成室间隔，中、后间隔与主动脉右瓣相邻，为不破坏间隔部的完整性，分离间隔部时同主动脉根部组织一同取下。Since the anterior septum of the right ventricular outflow tract fuses with the muscular tissue of the left ventricular outflow tract below the left aortic valve to form the interventricular septum, and the middle and posterior septa are adjacent to the right aortic valve, the septal part is separated in order not to destroy the integrity of the septal part It was removed together with the aortic root tissue.
3)沿肺动脉瓣下缘，自肺动脉右瓣最低点至左瓣最低点作水平横切，深至主动脉根部；3) Along the lower border of the pulmonary valve, make a horizontal transection from the lowest point of the right pulmonary valve to the lowest point of the left valve, deep to the root of the aorta;
4)自肺动脉右瓣与左瓣最低点，垂直于肺动脉瓣下缘横切线，纵切右心室流出道间隔部至室上嵴，深至主动脉根部；4) From the lowest point of the right and left pulmonary valves, perpendicular to the transverse line of the inferior border of the pulmonary valve, cut longitudinally from the septum of the right ventricular outflow tract to the supraventricular ridge, and deep to the root of the aorta;
5)平行于肺动脉瓣下缘横切线，相切于室上嵴最高点作横切，深至主动脉根部，分离出右心室流出道间隔部与相邻主动脉根部组织；5) Parallel to the transverse line of the lower edge of the pulmonary valve, and tangent to the highest point of the supraventricular crest, make a transverse cut, deep to the aortic root, and separate the right ventricular outflow tract septum and the adjacent aortic root tissue;
6)沿肺动脉瓣下缘，自肺动脉左瓣最低点作水平横切至前室间沟，距水平切线1-1.5cm处作平行切线至前室间沟，分离出右心室流出道前游离壁；6) Along the lower edge of the pulmonary valve, make a horizontal crosscut from the lowest point of the left pulmonary valve to the anterior interventricular groove, and make a parallel tangent to the anterior interventricular groove at a distance of 1-1.5 cm from the horizontal tangent line, and separate the free wall in front of the right ventricular outflow tract ;
7)统一纵切取材，脱水、包埋、切片、染色处理，依次观察右心室流出道间隔部、前游离壁的心内膜层、心肌层、心外膜层组织学结构，是否有脂肪替代、纤维化、炎性细胞浸润、心肌细胞排列紊乱。7) Uniform longitudinal sectioning, dehydration, embedding, slicing, and staining, and sequentially observe the histological structure of the septal part of the right ventricular outflow tract, the endocardium, myocardium, and epicardium of the anterior free wall, and whether there is fat replacement , fibrosis, inflammatory cell infiltration, myocardial cell arrangement disorder.
优选的，所述步骤2)肺动脉瓣长度包括肺动脉瓣的前瓣、右瓣和左瓣的长度。Preferably, the step 2) the length of the pulmonary valve includes the lengths of the anterior valve, the right valve and the left valve of the pulmonary valve.
优选的，所述步骤7)间隔部的长宽高为1.0cm×0.3cm×1.0cm；前游离壁的长宽高为1.0cm×0.3cm×0.3cm。Preferably, the length, width and height of the spacer in step 7) are 1.0 cm×0.3 cm×1.0 cm; the length, width and height of the front free wall are 1.0 cm×0.3 cm×0.3 cm.
优选的，所述间隔部包括前间隔、中间隔和后间隔。Preferably, the partition includes a front partition, a middle partition and a rear partition.
优选的，所述步骤1)心脏为已死亡人体的心脏。Preferably, the step 1) heart is the heart of a dead human body.
优选的，所述步骤1)心脏为已死亡动物体的心脏。Preferably, the step 1) heart is the heart of a dead animal.
本发明的有益效果为：The beneficial effects of the present invention are:
1)检查时由肺动脉前瓣与左瓣连接处剪开，避免了心脏开腔时对肺动脉瓣(尤其是前瓣)的破坏，便于后续对肺动脉瓣结构进行研究；1) During the inspection, the junction of the anterior pulmonary valve and the left valve was cut to avoid damage to the pulmonary valve (especially the anterior valve) when the heart was opened, and facilitate subsequent research on the structure of the pulmonary valve;
2)在分离出RVOT间隔部与前游离壁的同时，避免了对肺动脉瓣(尤其是前瓣)、三尖瓣、房室结的破坏，便于后续对以上结构的检查；2) While separating the RVOT septum and the anterior free wall, it avoids damage to the pulmonary valve (especially the anterior valve), tricuspid valve, and atrioventricular node, which facilitates subsequent inspection of the above structures;
3)创立并准确记录了RVOT的多项形态学指标，确定了RVOT的取材部位与取材方法，为RVOT功能解剖学、组织形态学等研究项目提供了科学、系统性的检查方法。3) Established and accurately recorded a number of morphological indicators of RVOT, determined the location and method of sampling RVOT, and provided scientific and systematic inspection methods for research projects such as RVOT functional anatomy and histomorphology.
附图说明Description of drawings
图1为RVOT全貌图，其中A-前瓣；R-右瓣；L-左瓣；Septum-红线区域，间隔部；Freewall-游离壁；Figure 1 is a general view of the RVOT, where A-anterior lobe; R-right lobe; L-left lobe; Septum-red line area, septum; Freewall-free wall;
图2为RVOT各项检测指标图；Figure 2 is a diagram of various detection indicators of RVOT;
图3为RVOT游离壁厚度图；Figure 3 is a diagram of the thickness of the RVOT free wall;
图4为RVOT间隔部厚度图。Figure 4 is a diagram of the thickness of the RVOT spacer.
具体实施方式Detailed ways
本发明提供了一种右心室流出道的检查方法，包括以下步骤：The invention provides a method for checking the right ventricular outflow tract, comprising the following steps:
1)自上而下，于肺动脉瓣前瓣与左瓣之间连接处，沿前室间沟至心尖，打开心脏的右心室，充分暴露右心室流出道的间隔部；1) From top to bottom, open the right ventricle of the heart at the connection between the anterior valve of the pulmonary valve and the left valve, along the anterior interventricular groove to the apex, and fully expose the septum of the right ventricular outflow tract;
2)检查肺动脉瓣、右心室流出道是否完整，依次测量肺动脉各瓣长度、肺动脉瓣下缘平面周长、肺动脉瓣上缘平面周长、肺动脉瓣下缘与肺动脉瓣上缘的中间平面周长、室上嵴最高点至肺动脉瓣膜下缘平面最短距离、右心室流出道的游离壁和右心室流出道的间隔部厚度；2) Check whether the pulmonary valve and the right ventricular outflow tract are complete, and measure the length of each valve of the pulmonary artery, the circumference of the lower edge of the pulmonary valve, the circumference of the upper edge of the pulmonary valve, and the circumference of the middle plane between the lower edge of the pulmonary valve and the upper edge of the pulmonary valve. , the shortest distance from the highest point of the supraventricular ridge to the lower border of the pulmonary valve, the thickness of the free wall of the right ventricular outflow tract and the septum of the right ventricular outflow tract;
3)沿肺动脉瓣下缘，自肺动脉右瓣最低点至左瓣最低点作水平横切，深至主动脉根部；3) Along the lower border of the pulmonary valve, make a horizontal transection from the lowest point of the right pulmonary valve to the lowest point of the left valve, deep to the root of the aorta;
4)自肺动脉右瓣与左瓣最低点，垂直于肺动脉瓣下缘横切线，纵切右心室流出道间隔部至室上嵴，深至主动脉根部；4) From the lowest point of the right and left pulmonary valves, perpendicular to the transverse line of the inferior border of the pulmonary valve, cut longitudinally from the septum of the right ventricular outflow tract to the supraventricular ridge, and deep to the root of the aorta;
5)平行于肺动脉瓣下缘横切线，相切于室上嵴最高点作横切，深至主动脉根部，可分离出右心室流出道间隔部与相邻主动脉根部组织；5) Parallel to the transverse line of the lower edge of the pulmonary valve, and tangential to the highest point of the supraventricular crest, the transverse section is made as deep as the aortic root, which can separate the septal part of the right ventricular outflow tract and the adjacent aortic root tissue;
6)沿肺动脉瓣下缘，自肺动脉左瓣最低点作水平横切至前室间沟，距水平切线1-1.5cm处作平行切线至前室间沟，可分离出右心室流出道前游离壁；6) Along the lower edge of the pulmonary valve, make a horizontal crosscut from the lowest point of the left pulmonary valve to the anterior interventricular groove, and make a parallel tangent to the anterior interventricular groove at a distance of 1-1.5 cm from the horizontal tangent line, and then separate the anterior free right ventricular outflow tract wall;
7)统一纵切取材，脱水、包埋、切片、染色处理，依次观察右心室流出道间隔部、前游离壁的心内膜层、心肌层、心外膜层组织学结构，是否有脂肪替代、纤维化、炎性细胞浸润、心肌细胞排列紊乱。7) Uniform longitudinal sectioning, dehydration, embedding, slicing, and staining, and sequentially observe the histological structure of the septal part of the right ventricular outflow tract, the endocardium, myocardium, and epicardium of the anterior free wall, and whether there is fat replacement , fibrosis, inflammatory cell infiltration, myocardial cell arrangement disorder.
本发明自上而下，于肺动脉瓣前瓣与左瓣之间连接处，沿前室间沟至心尖，打开心脏的右心室，充分暴露右心室流出道的间隔部。在本发明中，所述心脏优选为已死亡人体的心脏或已死亡动物体的心脏，其中人体心脏来自于中山大学司法鉴定中心尸体检验案例。The present invention opens the right ventricle of the heart from top to bottom at the joint between the anterior valve of the pulmonary artery and the left valve, along the anterior interventricular groove to the apex of the heart, and fully exposes the septum of the right ventricular outflow tract. In the present invention, the heart is preferably the heart of a dead human body or the heart of a dead animal body, wherein the human heart comes from an autopsy case of the Forensic Center of Sun Yat-sen University.
本发明首先检查肺动脉瓣、右心室流出道是否完整，再依次测量肺动脉各瓣长度、肺动脉瓣下缘平面周长、肺动脉瓣上缘平面周长、肺动脉瓣下缘与肺动脉瓣上缘的中间平面周长、室上嵴最高点至肺动脉瓣膜下缘平面最短距离、右心室流出道的游离壁和右心室流出道的间隔部厚度。在本发明中，所述肺动脉瓣长度优选包括肺动脉瓣的前瓣、右瓣和左瓣的长度。The present invention firstly checks whether the pulmonary valve and the right ventricular outflow tract are complete, and then measures the length of each valve of the pulmonary artery, the circumference of the lower border of the pulmonary valve, the circumference of the upper border of the pulmonary valve, and the middle plane between the lower border of the pulmonary valve and the upper border of the pulmonary valve. Circumference, the shortest distance from the highest point of the supraventricular ridge to the lower edge of the pulmonary valve, the thickness of the free wall of the right ventricular outflow tract and the septum of the right ventricular outflow tract. In the present invention, the length of the pulmonary valve preferably includes the lengths of the anterior valve, the right valve and the left valve of the pulmonary valve.
本发明沿肺动脉瓣下缘，自肺动脉右瓣最低点至左瓣最低点作水平横切，深至主动脉根部。The present invention makes a horizontal transverse cut along the lower edge of the pulmonary valve, from the lowest point of the right valve of the pulmonary artery to the lowest point of the left valve, and goes deep to the root of the aorta.
本发明自肺动脉右瓣与左瓣最低点，垂直于肺动脉瓣下缘横切线，纵切右心室流出道间隔部至室上嵴，深至主动脉根部。The invention starts from the lowest point of the right and left pulmonary valves, perpendicular to the transverse line of the lower edge of the pulmonary valve, longitudinally cuts the septum of the outflow tract of the right ventricle to the supraventricular ridge, and goes deep to the root of the aorta.
本发明平行于肺动脉瓣下缘横切线，相切于室上嵴最高点作横切，深至主动脉根部，可分离出右心室流出道间隔部与相邻主动脉根部组织。The present invention is parallel to the transverse line of the lower border of the pulmonary valve, tangent to the highest point of the supraventricular crest, and cuts deep to the root of the aorta to separate the septum of the right ventricular outflow tract and the tissue of the adjacent root of the aorta.
本发明沿肺动脉瓣下缘，自肺动脉左瓣最低点作水平横切至前室间沟，距水平切线1-1.5cm处作平行切线至前室间沟，可分离出右心室流出道前游离壁。The present invention cuts horizontally from the lowest point of the left pulmonary valve to the anterior interventricular groove along the lower edge of the pulmonary valve, and makes a parallel tangent to the anterior interventricular groove at a distance of 1-1.5 cm from the horizontal tangent, so as to separate the anterior free cell of the right ventricular outflow tract. wall.
本发明对右心室流出道的间隔部与前游离壁进行取材，统一采用纵切。在本发明中，所述间隔部的规格优选为1.0cm(长)×0.3cm(宽)×1.0cm(高)，前游离壁的规格优选为1.0cm(长)×0.3cm(宽)×0.3cm(高)。在本发明中，所述间隔部优选包括前间隔、中间隔和后间隔。本发明对脱水和包埋的方法没有特殊限定，本领域技术人员依据常规操作即可。In the present invention, materials are obtained from the septal portion and the anterior free wall of the right ventricular outflow tract, and a longitudinal section is uniformly adopted. In the present invention, the specification of the spacer is preferably 1.0cm (length)×0.3cm (width)×1.0cm (height), and the specification of the front free wall is preferably 1.0cm (length)×0.3cm (width)× 0.3cm (high). In the present invention, the partition preferably includes a front partition, a middle partition and a rear partition. The method of dehydration and embedding is not particularly limited in the present invention, and those skilled in the art can follow routine operations.
本发明做组织切片、染色，依次观察右心室流出道的心内膜层、心肌层、心外膜层组织学结构，是否有脂肪替代、纤维化、炎性细胞浸润、心肌细胞排列紊乱。本发明对制备组织切片和染色的方法没有特殊限定，本领域技术人员依据常规方法即可。In the present invention, the histological structure of the endocardium, myocardium, and epicardium of the right ventricular outflow tract is observed sequentially by sectioning and staining the tissue, and whether there is fat replacement, fibrosis, inflammatory cell infiltration, and cardiac muscle cell arrangement disorder. In the present invention, there are no special limitations on the methods for preparing tissue sections and staining, and those skilled in the art may follow conventional methods.
下面结合实施例对本发明提供的技术方案进行详细的说明，但是不能把它们理解为对本发明保护范围的限定。The technical solutions provided by the present invention will be described in detail below in conjunction with the examples, but they should not be interpreted as limiting the protection scope of the present invention.
实施例1Example 1
一种右心室流出道的检查方法，步骤如下：A method for examining the right ventricular outflow tract, the steps are as follows:
1)自上而下，于肺动脉瓣前瓣与左瓣之间连接处，沿前室间沟(左前降支位置)至心尖，打开已死亡人体心脏(来自于中山大学司法鉴定中心尸体检验案例)的右心室，充分暴露RVOT间隔部的同时，防止肺动脉瓣被破坏(见图1)；1) From top to bottom, open the dead human heart at the junction between the anterior valve of the pulmonary artery and the left valve, along the anterior interventricular groove (the position of the left anterior descending branch) to the apex of the heart (from the autopsy case of the Forensic Center of Sun Yat-sen University ) of the right ventricle, while fully exposing the RVOT septum, to prevent the destruction of the pulmonary valve (see Figure 1);
2)观察与测量：检查肺动脉瓣、RVOT是否完整，依次测量肺动脉瓣(前、右、左瓣)长度、肺动脉瓣下缘平面周长(sub-valve，SBV)、肺动脉瓣上缘平面周长(supra-valve，SPV)、SBV与SPV中间平面周长(mid-valve，MV)、室上嵴最高点至肺动脉瓣膜下缘最短距离(SC-PV，记录距离瓣膜)、RVOT游离壁与间隔部厚度(见图2～4)；2) Observation and measurement: check whether the pulmonary valve and RVOT are complete, measure the length of the pulmonary valve (front, right, and left), the circumference of the lower edge of the pulmonary valve (sub-valve, SBV), and the circumference of the upper edge of the pulmonary valve (supra-valve, SPV), mid-plane circumference of SBV and SPV (mid-valve, MV), the shortest distance from the highest point of the supraventricular ridge to the lower edge of the pulmonary valve (SC-PV, recording the distance from the valve), RVOT free wall and septum Internal thickness (see Figure 2-4);
3)沿肺动脉瓣下缘，自肺动脉右瓣最低点至左瓣最低点作水平横切，深至主动脉根部；3) Along the lower border of the pulmonary valve, make a horizontal transection from the lowest point of the right pulmonary valve to the lowest point of the left valve, deep to the root of the aorta;
4)自肺动脉右瓣与左瓣最低点，垂直于肺动脉瓣下缘横切线，纵切RVOT间隔部至室上嵴，深至主动脉根部；4) From the lowest point of the right and left pulmonary valves, perpendicular to the transverse line of the lower border of the pulmonary valve, longitudinally cut the RVOT septum to the supraventricular crest, and deep to the aortic root;
5)平行于肺动脉瓣下缘横切线，相切于室上嵴最高点作横切，深至主动脉根部，分离出RVOT间隔部与相邻主动脉根部组织；5) Parallel to the transverse line of the lower edge of the pulmonary valve, and tangent to the highest point of the supraventricular crest, make a transverse cut, deep to the aortic root, and separate the RVOT septum and the adjacent aortic root tissue;
6)沿肺动脉瓣下缘，自肺动脉左瓣最低点作水平横切至前室间沟，距水平切线1-1.5cm处作平行切线至前室间沟，分离出RVOT前游离壁；6) Along the lower edge of the pulmonary valve, make a horizontal crosscut from the lowest point of the left pulmonary valve to the anterior interventricular groove, and make a parallel tangent to the anterior interventricular groove at a distance of 1-1.5 cm from the horizontal tangent line, and separate the anterior free wall of the RVOT;
7)取材、脱水、包埋、切片、染色处理：统一采用纵切，取1.0cm(长)×0.3cm(宽)×1.0cm(高)的间隔部(前、中、后间隔)与1.0cm(长)×0.3cm(宽)×0.3cm(高)的前游离壁作组织学检查，染色方法选择Masson染色法；7) Material collection, dehydration, embedding, slicing, and staining: adopt longitudinal section uniformly, and take 1.0cm (length) × 0.3cm (width) × 1.0cm (height) intervals (anterior, middle, and posterior intervals) and 1.0 cm (length) × 0.3cm (width) × 0.3cm (height) of the anterior free wall for histological examination, the staining method is Masson staining;
8)依次观察RVOT间隔部、前游离壁的心内膜层、心肌层、心外膜层是否有纤维化。其中间隔部与主动脉根部相邻，仅有心内膜层与心肌层。8) Observe whether there is fibrosis in the RVOT septum, the endocardium, myocardium, and epicardium of the anterior free wall in sequence. Among them, the septum is adjacent to the aortic root, and there are only endocardium and myocardium.
附RVOT形态学检查指标(见表1)Attached are the RVOT morphological examination indicators (see Table 1)
表1RVOT形态学检查指标记录表Table 1 RVOT Morphological Inspection Index Record Form
注：Note:
肺动脉瓣膜长度：测量半月瓣上缘间距，不完整部分瓣膜累加计算，共测量3瓣(肺动脉前瓣Anterior valve、肺动脉右瓣Right valve、肺动脉左瓣Left valve)；Pulmonary valve length: measure the distance between the upper edges of the semilunar valves, and calculate the cumulative value of the incomplete valves, and measure 3 valves in total (anterior valve of the pulmonary artery, right valve of the pulmonary artery, and left valve of the pulmonary artery);
A—SBV，即sub-valve，肺动脉瓣下缘最低点水平连线长度；A—SBV, that is, sub-valve, the length of the horizontal line connecting the lowest point of the lower edge of the pulmonary valve;
B—SPV，即supra-valve，肺动脉瓣上缘尖端水平连线长度；B—SPV, that is, supra-valve, the length of the horizontal line connecting the tip of the upper edge of the pulmonary valve;
C—MV，即mid-valve，SBV与SPV中间平面，平行于SBV与SPV长度；C—MV, that is, mid-valve, the middle plane of SBV and SPV, parallel to the length of SBV and SPV;
平均RVOT口周长＝(A+B+C)/3；Average RVOT mouth circumference = (A+B+C)/3;
室上嵴最高点至肺动脉瓣膜下缘最短距离(SC-PV，supraventricular crest-pulmonary valve)，即室上嵴最高点处作水平切线，向上作垂线至半月瓣下缘距离，为RVOT最短距离；The shortest distance from the highest point of the supraventricular crest to the lower edge of the pulmonary valve (SC-PV, supraventricular crest-pulmonary valve), that is, the horizontal tangent line drawn from the highest point of the supraventricular crest, and the distance from the vertical line upward to the lower edge of the semilunar valve is the shortest distance of RVOT ;
距离最近瓣膜下缘距离，即左瓣、右瓣或左右瓣之间；The distance from the lower edge of the nearest valve, that is, the left valve, right valve or between the left and right valves;
壁厚(F)，即free wall thickness，游离壁厚度，取前瓣与右瓣连接处下方、肺动脉瓣下缘平面处心肌壁厚度；壁厚(S)，即septum thickness，间隔部厚度，取右与左瓣连接处下方、肺动脉瓣下缘平面处心肌壁厚度。Wall thickness (F), that is, free wall thickness, the thickness of the free wall, is taken as the thickness of the myocardium wall below the joint between the anterior valve and the right valve, and at the plane of the lower edge of the pulmonary valve; wall thickness (S), that is, septum thickness, and the thickness of the septum, is taken as Myocardial wall thickness below the junction of the right and left valves and at the plane of the inferior edge of the pulmonary valve.
肺动脉各瓣膜、SBV、SPV、MV、SC-PV单位为cm，游离壁与间隔部厚度单位为mm。The units of pulmonary artery valves, SBV, SPV, MV, and SC-PV are cm, and the unit of thickness of free wall and septum is mm.
从以上实施例中可以得出，死后人体心脏右心室流出道多项功能解剖学形态数据的测量方法，包括右心室流出道口的周长、间隔部与游离壁的厚度、最短间隔部长度。另外，取材后利用Masson染色法可观察右心室流出道是否存在纤维化。From the above embodiments, it can be concluded that the measurement method of multiple functional anatomical data of the right ventricular outflow tract of the human heart after death includes the circumference of the right ventricular outflow tract opening, the thickness of the septum and free wall, and the length of the shortest septum. In addition, the Masson staining method can be used to observe whether there is fibrosis in the right ventricular outflow tract after sampling.
以上所述仅是本发明的优选实施方式，应当指出，对于本技术领域的普通技术人员来说，在不脱离本发明原理的前提下，还可以做出若干改进和润饰，这些改进和润饰也应视为本发明的保护范围。The above is only a preferred embodiment of the present invention, it should be pointed out that, for those of ordinary skill in the art, without departing from the principle of the present invention, some improvements and modifications can also be made, and these improvements and modifications can also be made. It should be regarded as the protection scope of the present invention.
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