Miller A J, DeBoer A, Pick R, Van Pelt L, Palmer A S, Huber M P
Department of Medicine, Northwestern University Medical School, Chicago, Illinois.
Lymphology. 1988 Dec;21(4):227-33.
The purpose of this study was to characterize definitively the lymphatic drainage system of the pericardial space in the dog. The reports on this subject, based on dissection experiments and acute dye injections, remain controversial, and our own previous studies have been incomplete. Seventeen dogs were studied using a radiographic technique. Micropulverized barium sulfate instilled into the pericardial sac was followed with serial chest x-rays in seven dogs with intact cardiac lymphatics, in seven dogs after section of the cardiac lymphatic drainage node (the cardiac lymph node) in the right upper mediastinum, and in three dogs after resection of cardiac drainage lymphatic nodes in the left upper mediastinum. These studies revealed that the lymphatic drainage of the pericardial space is via (a) the principal coronary lymphatic which drains from the left ventricular muscle and passes to the right upper mediastinum via the cardiac lymph node, (b) the lesser coronary lymphatic which drains the right ventricular muscle and passes to the left upper mediastinum, and (c) bilateral internal mammary (parasternal) lymphatic chains. These observations are important in planning experimental approaches to the effects of impairment of lymph drainage from the pericardial space. An understanding of the lymph drainage from the pericardial space may prove significant to understanding fibrotic reactions within it and the pathologic mechanisms of such entities as constrictive pericarditis.
本研究的目的是明确犬心包腔的淋巴引流系统。基于解剖实验和急性染料注射的关于该主题的报告仍存在争议，我们此前的研究也并不完整。使用放射成像技术对17只犬进行了研究。在7只心脏淋巴管完整的犬、7只右上纵隔心脏淋巴引流节点（心淋巴结）切断术后的犬以及3只左上纵隔心脏引流淋巴结切除术后的犬中，向心包腔内注入微粉化硫酸钡后进行系列胸部X光检查。这些研究表明，心包腔的淋巴引流途径为：（a）主要冠状淋巴管，从左心室肌引流，经心淋巴结至右上纵隔；（b）较小冠状淋巴管，引流右心室肌，至左上纵隔；（c）双侧胸廓内（胸骨旁）淋巴链。这些观察结果对于规划心包腔淋巴引流受损影响的实验方法具有重要意义。了解心包腔的淋巴引流可能对理解其中的纤维化反应以及缩窄性心包炎等疾病的病理机制具有重要意义。
