{"id":38694,"date":"2024-07-23T05:10:13","date_gmt":"2024-07-23T05:10:13","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=38694"},"modified":"2024-07-23T05:10:13","modified_gmt":"2024-07-23T05:10:13","slug":"%e8%85%94%e5%86%85%e6%8a%80%e6%9c%af%e6%b2%bb%e7%96%97-kommerell-%e6%86%a9%e5%ae%a4%e7%9a%84%e4%b8%b4%e5%ba%8a%e7%a0%94%e7%a9%b6","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=38694","title":{"rendered":"\u8154\u5185\u6280\u672f\u6cbb\u7597 Kommerell \u61a9\u5ba4\u7684\u4e34\u5e8a\u7814\u7a76"},"content":{"rendered":"

Kommerell \u61a9\u5ba4\u662f\u5148\u5929\u6027\u75be\u75c5\uff0c\u4e8e 1936 \u5e74\u7531\u5fb7\u56fd\u7684 Burckhard F. Kommerell \u9996\u6b21\u62a5\u9053\uff0c\u6307\u964d\u4e3b\u52a8\u8109\u8d77\u59cb\u90e8\u7684\u7624\u6837\u6269\u5f20\u5e76\u53d1\u51fa\u8ff7\u8d70\u9501\u9aa8\u4e0b\u52a8\u8109\uff0c\u5e38\u4f34\u53d1\u52a8\u8109\u7624\u7834\u88c2\u53ca\u52a8\u8109\u5939\u5c42[1]<\/sup>\u3002\u6709\u7814\u7a76[2]<\/sup>\u5bf9\u5207\u9664\u7684 Kommerell \u61a9\u5ba4\u8fdb\u884c\u7ec4\u7ec7\u5b66\u5206\u6790\uff0c\u53ef\u89c1\u56ca\u6027\u4e2d\u819c\u574f\u6b7b\uff0c\u6545\u61a9\u5ba4\u52a8\u8109\u58c1\u5f39\u6027\u6781\u5dee\uff0c\u6613\u7834\u788e\uff0c\u8fd9\u4e5f\u662f\u61a9\u5ba4\u5bb9\u6613\u4ea7\u751f\u5939\u5c42\u6216\u7834\u88c2\u7684\u539f\u56e0\u3002\u9488\u5bf9 Kommerell \u61a9\u5ba4\u9700\u91c7\u53d6\u79ef\u6781\u6cbb\u7597\uff0c\u4f46\u662f\u91c7\u7528\u4f20\u7edf\u5f00\u80f8\u624b\u672f\u5177\u6709\u8f83\u9ad8\u7684\u5e76\u53d1\u75c7\u7387\u548c\u75c5\u6b7b\u7387\uff1b\u6742\u4ea4\u624b\u672f\u9700\u8981\u91cd\u5efa\u53d7\u7d2f\u53ca\u7684\u8840\u7ba1\uff0c\u9884\u91cd\u5efa\u7684\u5206\u652f\u8840\u7ba1\u53ef\u80fd\u56e0\u8d70\u5f62\u53d8\u5f02\u800c\u4f4d\u7f6e\u8fc7\u6df1\uff0c\u5bfc\u81f4\u65e0\u6cd5\u5145\u5206\u66b4\u9732\uff0c\u53ef\u80fd\u6709\u91cd\u5efa\u5931\u8d25\u7684\u98ce\u9669\u3002\u968f\u7740\u8154\u5185\u6280\u672f\u7684\u8fdb\u6b65\uff0c\u80f8\u4e3b\u52a8\u8109\u8154\u5185\u4fee\u590d\u672f\u5f97\u5230\u5e7f\u6cdb\u5e94\u7528\uff0c\u76ee\u524d\u91c7\u7528\u5b8c\u5168\u8154\u5185\u4fee\u590d\u672f\u6cbb\u7597 Kommerell \u61a9\u5ba4\u7684\u62a5\u9053\u6781\u5c11\u3002\u7b14\u8005\u73b0\u5bf9\u9996\u90fd\u533b\u79d1\u5927\u5b66\u5ba3\u6b66\u533b\u9662\uff08\u4ee5\u4e0b\u7b80\u79f0\u201c\u6211\u9662\u201d\uff092018 \u5e74\u6536\u6cbb\u7684 1 \u4f8b Kommerell \u61a9\u5ba4\u60a3\u8005\u91c7\u7528\u80f8\u4e3b\u52a8\u8109\u5b8c\u5168\u8154\u5185\u4fee\u590d\u6cbb\u7597\u7684\u6280\u672f\u62a5\u9053\u5982\u4e0b\u3002<\/p>\n

\n\t\t1   \u8d44\u6599\u4e0e\u65b9\u6cd5
\n\t<\/h2>\n

\n\t\t1.1   \u75c5\u53f2\u7b80\u4ecb
\n\t<\/h3>\n

\u60a3\u8005\uff0c\u7537\uff0c64 \u5c81\uff0c\u56e0\u201c\u53d1\u73b0\u5de6\u4e0a\u80a2\u65e0\u8109 3 \u5e74\u201d\u5165\u9662\u3002\u65e0\u541e\u54bd\u56f0\u96be\u3001\u547c\u5438\u56f0\u96be\u53ca\u5598\u9e23\u3002\u65e2\u5f80\u6709\u9ad8\u8840\u538b\u3001\u7cd6\u5c3f\u75c5\u3002\u5165\u9662\u65f6\u67e5\u4f53\uff1a\u5de6\u4e0a\u80a2\u8109\u640f\u672a\u89e6\u53ca\uff0c\u53f3\u4e0a\u80a2\u8109\u640f\u640f\u52a8\u6709\u529b\uff0c\u53cc\u4fa7\u8109\u538b\u5dee\u8fd1 50 mm Hg\uff081 mm Hg=0.133 kg\uff09\uff0c\u60a3\u8005\u5728\u8fd9 3 \u5e74\u95f4\u672a\u5230\u533b\u9662\u5c31\u8bca\uff0c\u73b0\u4e3a\u8fdb\u4e00\u6b65\u67e5\u660e\u75c5\u56e0\u6765\u6211\u9662\u3002<\/p>\n

\n\t\t1.2   \u5b9e\u9a8c\u5ba4\u68c0\u67e5
\n\t<\/h3>\n

\u60a3\u8005\u5165\u9662\u540e\u67e5\u8840\u5e38\u89c4\u3001\u5c3f\u5e38\u89c4\u3001\u51dd\u8840\u529f\u80fd\u3001\u809d\u529f\u80fd\u3001\u80be\u529f\u80fd\u3001\u8840\u6c89\u53ca C \u53cd\u5e94\u86cb\u767d\u5747\u5728\u6b63\u5e38\u8303\u56f4\uff0c\u8840\u7cd6 6.80 mmol\/L\uff0c\u4f4e\u5bc6\u5ea6\u8102\u86cb\u767d 2.96 mmol\/L\u3002<\/p>\n

\n\t\t1.3   \u5f71\u50cf\u5b66\u68c0\u67e5
\n\t<\/h3>\n

\u60a3\u8005\u5165\u9662\u540e\u884c\u8d85\u58f0\u68c0\u67e5\u63d0\u793a\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u91cd\u5ea6\u72ed\u7a84\u5e76\u5de6\u690e\u52a8\u8109\u76d7\u8840\uff0c\u8fdb\u4e00\u6b65\u884c CT \u8840\u7ba1\u4e09\u7ef4\u91cd\u5efa\u663e\u793a\uff08\u56fe 1a\u20131c\uff09\uff1a\u53f3\u4f4d\u4e3b\u52a8\u8109\u5f13\uff0c\u8ff7\u8d70\u5de6\u4fa7\u9501\u9aa8\u4e0b\u52a8\u8109\u4f34 Kommerell \u61a9\u5ba4\uff0c\u61a9\u5ba4\u5b54\u76f4\u5f84 36 mm\uff1b\u9501\u9aa8\u4e0b\u52a8\u8109\u8d77\u59cb\u90e8\u91cd\u5ea6\u72ed\u7a84\uff0c\u4e3b\u52a8\u8109\u5f13\u4f9d\u6b21\u53d1\u51fa\u5de6\u9888\u603b\u52a8\u8109\u3001\u53f3\u9888\u603b\u52a8\u8109\u3001\u53f3\u9501\u9aa8\u4e0b\u52a8\u8109\u53ca\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u3002<\/p>\n

\t\t\t\t\u56fe1
\n\t\t\t\t\u672f\u524d\u53ca\u672f\u540e\u5f71\u50cf\u68c0\u67e5\u7ed3\u679c<\/p>\n

a\u2013c\uff1a\u672f\u524d\u589e\u5f3a CT \u8840\u7ba1\u9020\u5f71\u7ed3\u679c\uff0c\u767d\u8272\u7bad\u5934\u63d0\u793a Kommerell \u61a9\u5ba4\uff0c\u7ea2\u8272\u7bad\u5934\u63d0\u793a\u9501\u9aa8\u4e0b\u52a8\u8109\u8d77\u59cb\u8fdc\u7aef\u81a8\u5927\uff0c\u9ec4\u8272\u7bad\u5934\u63d0\u793a\u98df\u7ba1\uff0c\u84dd\u8272\u7bad\u5934\u63d0\u793a\u5de6\u690e\u52a8\u8109\uff1bd\u2013f\uff1a\u672f\u540e\u7b2c 12 \u4e2a\u6708\u65f6\u590d\u67e5\u589e\u5f3a CT \u8840\u7ba1\u9020\u5f71\u7ed3\u679c\uff0c\u767d\u8272\u7bad\u5934\u63d0\u793a Kommerell \u61a9\u5ba4\uff08\u8840\u6813\u5316\uff09\uff0c\u7ea2\u8272\u7bad\u5934\u63d0\u793a\u5f39\u7c27\u5708\u6813\u585e\u9501\u9aa8\u4e0b\u52a8\u8109\u8d77\u59cb\u8fdc\u7aef\u81a8\u5927\uff08\u8840\u6813\u5316\uff09\uff0c\u84dd\u8272\u7bad\u5934\u63d0\u793a\u672f\u540e\u5de6\u690e\u52a8\u8109\u8840\u6d41\u901a\u7545<\/p>\n

\t\t\t\t\u56fe\u9009\u9879\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/p>\n

\u4e0b\u8f7d\u5168\u5c3a\u5bf8\u56fe\u50cf<\/p>\n

\u4e0b\u8f7d\u5e7b\u706f\u7247<\/p>\n

\n\t\t1.4   \u672f\u524d\u8bc4\u4f30
\n\t<\/h3>\n

\n\t\t1.4.1   \u60a3\u8005\u72b6\u51b5\u8bc4\u4f30
\n\t<\/h4>\n

\u60a3\u8005\u4e3a\u4e2d\u5e74\u7537\u6027\uff0c\u65e2\u5f80\u4f53\u5065\uff0c\u6709\u9ad8\u8840\u538b\u53ca\u7cd6\u5c3f\u75c5\u53f2\uff0c\u60a3\u8005\u89c4\u5f8b\u670d\u7528\u964d\u538b\u836f\uff0c\u8840\u538b\u63a7\u5236\u826f\u597d\uff0c\u5fc3\u7535\u56fe\u53ca\u5fc3\u810f\u8d85\u58f0\u672a\u89c1\u660e\u663e\u5f02\u5e38\uff1b\u80f8\u7247\u53ca\u8840\u6c14\u672a\u89c1\u5f02\u5e38\uff1b\u60a3\u8005\u901a\u8fc7\u836f\u7269\u53ca\u996e\u98df\u63a7\u5236\u8840\u7cd6\u826f\u597d\uff0c\u672a\u89c1\u809d\u80be\u529f\u80fd\u5e76\u53d1\u75c7\uff0c\u65e2\u5f80\u65e0\u5438\u70df\u3001\u996e\u9152\u53f2\u3002<\/p>\n

\n\t\t1.4.2   \u624b\u672f\u53ef\u884c\u6027\u8bc4\u4f30
\n\t<\/h4>\n

\u901a\u8fc7\u672f\u524d\u8d85\u58f0\u53ef\u4ee5\u8bc4\u4f30\u690e\u52a8\u8109\u8840\u6d41\u53ca\u76d7\u8840\u60c5\u51b5\u3002\u901a\u8fc7 CT \u8840\u7ba1\u9020\u5f71\u68c0\u67e5\u53ef\u4ee5\u8bc4\u4f30\u4e3b\u52a8\u8109\u5f13\u5f62\u3001\u5f13\u90e8\u5206\u652f\u4e4b\u95f4\u7684\u5173\u7cfb\u4ee5\u53ca\u53cc\u4fa7\u690e\u52a8\u8109\u548c Willis \u73af\u60c5\u51b5\u3002\u7efc\u5408\u672f\u524d\u68c0\u67e5\uff0c\u60a3\u8005\u5de6\u4fa7\u690e\u52a8\u8109\u4e3a\u975e\u4f18\u52bf\u4fa7\u4e14\u5b58\u5728\u76d7\u8840\u3002\u4e00\u822c\u8ba4\u4e3a\uff0c\u6ee1\u8db3\u4ee5\u4e0b\u6761\u4ef6\u4e4b\u4e00\u8005\u53ef\u4ee5\u8003\u8651\u624b\u672f\u5e72\u9884\uff1a\u61a9\u5ba4\u5b54\u76f4\u5f84\u8d85\u8fc7 30 mm\u3001\u4e0e\u61a9\u5ba4\u76f8\u90bb\u7684\u4e3b\u52a8\u8109\u76f4\u5f84\u8d85\u8fc7 50 mm\u3001\u60a3\u8005\u6709\u4e25\u91cd\u7684\u538b\u8feb\u75c7\u72b6\u3001\u52a8\u8109\u5939\u5c42\u5f62\u6210\u3001\u690e\u52a8\u8109\u76d7\u8840\u81f4\u9885\u5185\u7f3a\u8840\u4e25\u91cd\u8005\u3002\u672c\u4f8b\u60a3\u8005\u6709\u76f8\u5e94\u6307\u5f81\uff0c\u53ef\u884c\u624b\u672f\u6cbb\u7597\u3002<\/p>\n

\n\t\t1.5   \u672f\u524d\u8ba8\u8bba
\n\t<\/h3>\n

\u7ed3\u5408\u60a3\u8005\u75c7\u72b6\u3001\u4f53\u5f81\u53ca\u5f71\u50cf\u5b66\u68c0\u67e5\u7ed3\u679c\u8bca\u65ad Kommerell \u61a9\u5ba4\u660e\u786e\u3002\u672f\u524d\u8bc4\u4f30\u53d1\u73b0\uff0c\u60a3\u8005\u5de6\u4fa7\u690e\u52a8\u8109\u4e3a\u975e\u4f18\u52bf\u4fa7\u4e14\u5b58\u5728\u76d7\u8840\uff0c\u82e5\u672f\u4e2d\u5c01\u95ed\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u5bfc\u81f4\u540e\u5faa\u73af\u7f3a\u8840\u53ef\u80fd\u6027\u6bd4\u8f83\u5c0f\uff0c\u60a3\u8005\u4e0d\u5b58\u5728\u98df\u7ba1\u538b\u8feb\u75c7\u72b6\uff0c\u7ecf\u8ba8\u8bba\u540e\u51b3\u5b9a\u884c\u8154\u5185\u4fee\u590d\u672f\u3001\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u5f39\u7c27\u5708\u6813\u585e\u5c01\u5835\u61a9\u5ba4\u3001\u4e3b\u52a8\u8109\u8986\u819c\u652f\u67b6\u690d\u5165\u672f\u3002\u60a3\u8005\u672f\u4e2d\u53ca\u672f\u540e\u53ef\u80fd\u53d1\u751f\u2160\u578b\u5185\u6f0f\uff0c\u672f\u4e2d\u9700\u51c6\u786e\u5b9a\u4f4d\u652f\u67b6\uff0c\u7ed9\u4e88\u8db3\u591f\u7684\u951a\u5b9a\u533a\uff1b\u5173\u4e8e\u2161\u578b\u5185\u6f0f\u7684\u53d1\u751f\uff0c\u53ef\u672f\u540e\u5bc6\u5207\u968f\u8bbf\u60a3\u8005\uff0c\u5927\u90e8\u5206\u60a3\u8005\u53ef\u8840\u6813\u5316\u3002\u53e6\u5916\uff0c\u60a3\u8005\u672f\u4e2d\u53ca\u672f\u540e\u53ef\u80fd\u53d1\u751f\u5de6\u690e\u52a8\u8109\u7f3a\u8840\uff0c\u672f\u4e2d\u53ef\u7ed9\u4e88\u5347\u9ad8\u8840\u538b\u7f13\u89e3\u7f3a\u8840\uff0c\u5e76\u53ef\u9884\u5148\u7403\u56ca\u963b\u65ad\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\uff0c\u89c2\u5bdf\u60a3\u8005\u5de6\u690e\u52a8\u8109\u53ca\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u7f3a\u8840\u60c5\u51b5\uff0c\u82e5\u5b58\u5728\u7f3a\u8840\uff0c\u9700\u884c\u9501\u9aa8\u4e0b\u52a8\u8109\u8f6c\u6d41\u91cd\u5efa\u9501\u9aa8\u4e0b\u52a8\u8109\u53ca\u690e\u52a8\u8109\u3002<\/p>\n

\n\t\t2   \u624b\u672f\u6b65\u9aa4
\n\t<\/h2>\n

\u60a3\u8005\u53d6\u4ef0\u5367\u4f4d\uff0c\u5728\u5c40\u90e8\u9ebb\u9189\u4e0b\uff0cSeldinger \u6280\u672f\u7a7f\u523a\u53f3\u80a1\u52a8\u8109\uff0c\u7f6e\u5165 7F \u8840\u7ba1\u77ed\u9798\uff08\u65e5\u672c Tempo \u516c\u53f8\uff09\uff0c\u4e8e\u53f3\u80a1\u52a8\u8109\u9884\u7f6e\u53cc\u7f1d\u5408\u5668\uff08\u7f8e\u56fd Abboott PerClose \u516c\u53f8\uff09\uff0c\u5e38\u89c4\u7ed9\u4e88\u809d\u7d20 100 U\/kg\uff08\u534e\u5317\u5236\u836f\u80a1\u4efd\u6709\u9650\u516c\u53f8\uff09\u3002\u7a7f\u523a\u53cc\u80b1\u52a8\u8109\uff0c\u7f6e\u5165 5F \u8840\u7ba1\u77ed\u9798\uff08\u65e5\u672c Tempo \u516c\u53f8\uff09\uff0c\u53f3\u80a1\u52a8\u8109\u884c\u5bfc\u7ba1\u9020\u5f71\u89c1\u61a9\u5ba4\u4f4d\u4e8e\u964d\u4e3b\u52a8\u8109\u524d\u58c1\uff0c\u4e3b\u52a8\u8109\u5f13\u4f9d\u6b21\u53d1\u51fa\u5de6\u9888\u603b\u52a8\u8109\u3001\u53f3\u9888\u603b\u52a8\u8109\u3001\u53f3\u9501\u9aa8\u4e0b\u52a8\u8109\u53ca\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\uff0c\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u8d77\u59cb\u4e8e\u61a9\u5ba4\u5e76\u91cd\u5ea6\u72ed\u7a84\uff0c\u5de6\u690e\u52a8\u8109\u7ea4\u7ec6\uff0c\u8840\u6db2\u5012\u6d41\u5165\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\uff0c\u53f3\u690e\u52a8\u8109\u6b63\u5411\u8840\u6d41\uff0c\u4e3a\u4f18\u52bf\u4fa7\u3002\u53f3\u80a1\u52a8\u8109\u5904\u5c06 7F \u77ed\u9798\u4ea4\u6362\u6210 18F \u7684\u957f\u9798\uff08\u7f8e\u56fd Gore \u516c\u53f8)\uff0c\u7ecf\u53f3\u80b1\u52a8\u8109\u7f6e\u5165\u732a\u5c3e\u5bfc\u7ba1\u5b9a\u4f4d\u9020\u5f71\uff08\u7f8e\u56fd Cook \u516c\u53f8\uff09\uff0c\u5c06 Relay \u8986\u819c\u652f\u67b6\u7ecf\u53f3\u80a1\u52a8\u8109\u5165\u8def\u690d\u5165\u964d\u4e3b\u52a8\u8109\uff0c\u652f\u67b6\u5934\u7aef\u4f4d\u4e8e\u53f3\u9501\u9aa8\u4e0b\u52a8\u8109\u8fb9\u7f18\uff0c\u9020\u5f71\u89c1\u652f\u67b6\u4f4d\u7f6e\u826f\u597d\uff0c\u672a\u89c1\u5185\u6f0f\u53ca\u79fb\u4f4d\u3002\u7ecf\u5de6\u80b1\u52a8\u8109\u5165\u8def\uff0c\u5c06\u5355\u5f2f\u5bfc\u7ba1\uff08\u65e5\u672c Tempo \u516c\u53f8\uff09\u901a\u8fc7\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u9009\u5165\u61a9\u5ba4\u5185\uff0c\u5728\u61a9\u5ba4\u5185\u91ca\u653e\u7f8a\u6bdb\u94a2\u4e1d\u5708 4 \u679a\uff08\u7f8e\u56fd Cook \u516c\u53f8\uff0c15 mm\uff09\uff0c\u5728\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u5185\u91ca\u653e\u7f8a\u6bdb\u94a2\u4e1d\u5708 4 \u679a\uff08\u7f8e\u56fd Cook \u516c\u53f8 15 mm \u8005 2 \u679a\u30018 mm \u8005 2 \u679a\uff09\uff0c\u518d\u6b21\u9020\u5f71\uff0c\u80f8\u4e3b\u52a8\u8109\u652f\u67b6\u4f4d\u7f6e\u826f\u597d\uff0c\u61a9\u5ba4\u672a\u89c1\u663e\u5f71\uff0c\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u8fdc\u7aef\u665a\u671f\u663e\u5f71\u3002\u7f1d\u5408\u5668\uff08\u7f8e\u56fd Abboott PerClose \u516c\u53f8\uff09\u7f1d\u5408\u53f3\u80a1\u52a8\u8109\u3002\u672f\u6bd5\uff0c\u624b\u672f\u65f6\u95f4 55 min\uff0c\u672f\u4e2d\u51fa\u8840\u91cf\u7ea6 20 mL\u3002<\/p>\n

\n\t\t3   \u672f\u540e\u8fc7\u7a0b
\n\t<\/h2>\n

\u60a3\u8005\u672f\u540e\u65e0\u5934\u6655\u3001\u5934\u75db\u3001\u89c6\u529b\u969c\u788d\u3001\u56db\u80a2\u75bc\u75db\u7b49\u4e0d\u826f\u75c7\u72b6\uff0c\u53cc\u4fa7\u8109\u538b\u5dee\u65e0\u663e\u8457\u53d8\u5316\uff0c\u4e0e\u672f\u524d\u57fa\u672c\u4e00\u81f4\u3002\u672f\u540e\u8d85\u58f0\u63d0\u793a\uff0c\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u76d7\u8840\u3002\u672f\u540e\u7b2c 6 \u5929\u65f6\u60a3\u8005\u5eb7\u590d\u51fa\u9662\u3002\u957f\u671f\u6297\u8840\u5c0f\u677f\u3001\u964d\u8102\u5bf9\u75c7\u5904\u7406\uff0c\u963f\u53f8\u5339\u6797 100 mg\uff081 \u6b21\/d\uff09\uff0c\u745e\u8212\u4f10\u4ed6\u6c40 10 mg\uff081 \u6b21\/d\uff09\u3002\u60a3\u8005\u672f\u540e\u91c7\u7528 CT \u8840\u7ba1\u9020\u5f71\uff08\u56fe 1d\u20131f\uff09\u968f\u8bbf\uff0c\u89c2\u5bdf\u652f\u67b6\u5f62\u6001\u3001\u5185\u6f0f\uff0c\u540c\u65f6\u4e86\u89e3\u6709\u65e0\u8111\u90e8\u3001\u4e0a\u80a2\u7f3a\u8840\u7b49\u5e76\u53d1\u75c7\u7684\u53d1\u751f\u3002\u51fa\u9662\u540e\u7b2c 12 \u4e2a\u6708\u968f\u8bbf\u65f6\uff0c\u65e0\u8111\u90e8\u53ca\u4e0a\u80a2\u7f3a\u8840\u75c7\u72b6\u53ca\u5176\u4ed6\u4e0d\u826f\u75c7\u72b6\u53d1\u751f\uff0c\u4e3b\u52a8\u8109\u5185\u652f\u67b6\u5f62\u6001\u826f\u597d\uff0c\u65e0\u79fb\u4f4d\uff0c\u65e0\u5185\u6f0f\uff0c\u61a9\u5ba4\u5145\u5206\u8840\u6813\u5316\u3002<\/p>\n

\n\t\t4   \u8ba8\u8bba
\n\t<\/h2>\n

\n\t\t4.1   Kommerell \u61a9\u5ba4\u7684\u75c5\u56e0\u53ca\u5206\u578b
\n\t<\/h3>\n

\n\t\t4.1.1   \u75c5\u56e0
\n\t<\/h4>\n

Kommerell \u61a9\u5ba4\u662f\u4e3b\u52a8\u8109\u61a9\u5ba4\u7684\u4e00\u79cd\u7279\u6b8a\u7c7b\u578b\u3002\u4e3b\u52a8\u8109\u61a9\u5ba4\u662f\u4e3b\u52a8\u8109\u5f13\u5148\u5929\u53d1\u80b2\u7578\u5f62\uff0c\u662f\u4e3b\u52a8\u8109\u5c40\u90e8\u6269\u5f20\uff0c\u5f53\u6269\u5f20\u7684\u4e3b\u52a8\u8109\u4e0a\u53d1\u51fa\u8ff7\u8d70\u9501\u9aa8\u4e0b\u52a8\u8109\u65f6\u88ab\u79f0\u4e3a Kommerell \u61a9\u5ba4[2]<\/sup>\u3002\u4eba\u7c7b\u4e3b\u52a8\u8109\u5f13\u7684\u53d1\u80b2\u8fc7\u7a0b\u662f\u7531\u65e9\u671f\u73af\u5f62\u4e3b\u52a8\u8109\u5f13\u9010\u6e10\u6f14\u53d8\u4e3a\u5355\u4e00\u4e3b\u52a8\u8109\u5f13\u7684\u8fc7\u7a0b\uff0c\u8fd9\u4e00\u6f14\u53d8\u8fc7\u7a0b\u82e5\u53d1\u751f\u5f02\u5e38\u5c06\u4f1a\u5bfc\u81f4\u8840\u7ba1\u7578\u5f62\u7684\u53d1\u751f\u3002\u5728\u80da\u80ce\u65e9\u671f\uff0c\u4e00\u822c\u5728 5\uff5e7 \u5468\u9010\u6e10\u5f62\u6210\u539f\u59cb\u7684 6 \u5bf9\u52a8\u8109\u5f13\uff0c\u5176\u4e2d\u7b2c 1\u30012\u30015 \u5bf9\u4e3b\u52a8\u8109\u5f13\u5927\u90e8\u5206\u6d88\u9000\uff0c\u7b2c 3 \u5bf9\u4e3b\u52a8\u8109\u5f13\u884d\u5316\u4e3a\u9888\u52a8\u8109\uff0c\u53cc\u4fa7\u7b2c 4 \u5bf9\u4e3b\u52a8\u8109\u5f13\u5206\u522b\u53d1\u51fa\u9501\u9aa8\u4e0b\u52a8\u8109\u3002\u7b2c 4 \u539f\u59cb\u80cc\u5f13\u672a\u80fd\u9000\u5316\u6d88\u5931\u5c31\u4f1a\u5f62\u6210\u4e3b\u52a8\u8109\u61a9\u5ba4\u3002\u8ff7\u8d70\u9501\u9aa8\u4e0b\u52a8\u8109\uff0c\u8d77\u6e90\u4e8e\u81a8\u5927\u7684\u4e3b\u52a8\u8109\u61a9\u5ba4\u5c31\u4f1a\u5f62\u6210 Kommerell \u61a9\u5ba4\u3002<\/p>\n

\n\t\t4.1.2   \u5206\u578b
\n\t<\/h4>\n

\u6839\u636e\u9501\u9aa8\u4e0b\u52a8\u8109\u7684\u8d77\u6e90\u5c06\u4e3b\u52a8\u8109\u61a9\u5ba4\u5206\u4e3a 3 \u578b\uff1a\u2160\u578b\uff0c\u5de6\u4fa7\u4e3b\u52a8\u8109\u5f13\u5e76\u53d1\u4e3b\u52a8\u8109\u61a9\u5ba4\u53ca\u8ff7\u8d70\u53f3\u9501\u9aa8\u4e0b\u52a8\u8109\uff1b\u2161\u578b\uff0c\u53f3\u4fa7\u4e3b\u52a8\u8109\u5f13\u4f34\u4e3b\u52a8\u8109\u61a9\u5ba4\u53ca\u8ff7\u8d70\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\uff1b\u2162\u578b\uff0c\u5bfc\u7ba1\u61a9\u5ba4\u3002\u5176\u4e2d\u7b2c\u2160\u3001\u2161\u578b\u88ab\u79f0\u4e3a Kommerell \u61a9\u5ba4\u3002\u56fd\u5185\u5b66\u8005[3]<\/sup>\u6309\u4e3b\u52a8\u8109\u5f13\u53d1\u80b2\u7684\u7578\u5f62\u4fa7\u522b\u5206\u4e3a\u5de6\u4f4d\u53ca\u53f3\u4f4d\u4e3b\u52a8\u8109\u5f13\uff0c\u6839\u636e\u8840\u7ba1\u5206\u652f\u7684\u60c5\u51b5\u518d\u8fdb\u884c\u5206\u7c7b\uff0c\u2160\u578b\uff0c\u955c\u9762\u5206\u652f\u578b\u5373\u9501\u9aa8\u4e0b\u52a8\u8109\u53ca\u9888\u52a8\u8109\u4f9d\u6b21\u8d77\u6e90\u4e8e\u4e3b\u52a8\u8109\u5f13\u5e76\u5448\u5bf9\u79f0\u5206\u5e03\uff1b\u2161\u578b\u5373\u4f34\u8ff7\u8d70\u9501\u9aa8\u4e0b\u52a8\u8109\u578b\u3002\u5f53\u7136\u4e5f\u5b58\u5728\u4e00\u4e9b\u5176\u4ed6\u7684\u7578\u5f62\uff0c\u5982\u5408\u5e76\u53cc\u5f13\u7578\u5f62\u7684 Kommerell \u61a9\u5ba4[4]<\/sup>\u548c\u53cc\u690e\u52a8\u8109\u8d77\u6e90\u5f02\u5e38\u7684 Kommerell\u61a9\u5ba4[5]<\/sup>\u3002\u672c\u75c5\u4f8b\u62a5\u9053\u4e2d\u8ba8\u8bba\u7684\u60a3\u8005\u6309\u7167 Salomonowitz\u5206\u578b[6]<\/sup>\u662f\u5178\u578b\u7684\u2161\u578b\uff0c\u5373\u53f3\u4f4d\u4e3b\u52a8\u8109\u5f13\u4f34\u8ff7\u8d70\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u5f00\u53e3\u8d77\u6e90\u4e8e Kommerell \u61a9\u5ba4\u3002Kommerell \u61a9\u5ba4\u8fd9\u79cd\u7c7b\u578b\u5f88\u5c11\u4f34\u6709\u5fc3\u810f\u7578\u5f62\uff0c\u4f46\u53ef\u4f34\u53d1\u6c14\u7ba1\u3001\u98df\u7ba1\u53d7\u538b\uff0c\u4e3b\u8981\u56e0\u4e3a\u2161\u578b\u53f3\u4f4d\u4e3b\u52a8\u8109\u5f13\uff0c\u52a8\u8109\u5bfc\u7ba1\u6216\u97e7\u5e26\u591a\u5728\u5de6\u4fa7\uff0c\u4f4d\u4e8e Kommerell \u61a9\u5ba4\u6216\u8ff7\u8d70\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u4e0e\u5de6\u80ba\u52a8\u8109\u4e4b\u95f4\uff0c\u8fd9\u6837\u5c31\u7531\u52a8\u8109\u5bfc\u7ba1\u6216\u97e7\u5e26\u3001\u5de6\u80ba\u52a8\u8109\u3001\u80ba\u52a8\u8109\u5e72\u3001\u5347\u4e3b\u52a8\u8109\u3001\u53f3\u4f4d\u4e3b\u52a8\u8109\u5f13\u3001Kommerell \u61a9\u5ba4\u3001\u8ff7\u8d70\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u7b49\u7ed3\u6784\u5f62\u6210\u4e86\u4e00\u4e2a\u5b8c\u6574\u7684\u8840\u7ba1\u73af\uff0c\u8be5\u8840\u7ba1\u73af\u901a\u5e38\u5f88\u5bbd\u677e\uff0c\u6240\u4ee5\u5927\u591a\u6570\u98df\u7ba1\u6216\u6c14\u7ba1\u538b\u8feb\u75c7\u72b6\u5f88\u8f7b\u5fae\u6216\u7f3a\u5982\u3002<\/p>\n

\n\t\t4.2   Kommerell \u61a9\u5ba4\u7684\u6d41\u884c\u75c5\u5b66\u7279\u5f81
\n\t<\/h3>\n

Kommerell \u61a9\u5ba4\u7684\u53d1\u75c5\u7387\u8f83\u4f4e\uff0c\u5176\u4e2d\u53f3\u9501\u9aa8\u4e0b\u52a8\u8109\u5f02\u5e38\u7684\u5de6\u4e3b\u52a8\u8109\u5f13\u60a3\u75c5\u7387\u4e3a 0.7%\uff5e2.0%[7]<\/sup>\uff0c\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u5f02\u5e38\u7684\u53f3\u4e3b\u52a8\u8109\u5f13\u60a3\u75c5\u7387\u4e3a 0.04%\uff5e0.4%[8]<\/sup>\u3002\u5f02\u4f4d\u7684\u9501\u9aa8\u4e0b\u52a8\u8109\u8d70\u5f62\u8def\u5f84\u4e0d\u540c\uff0c\u5176\u4e2d\u5f02\u5e38\u9501\u9aa8\u4e0b\u52a8\u8109\u7ecf\u98df\u7ba1\u540e\u5411\u4e0a\u901a\u5165\u4e0a\u80a2\u8005\u5360 80%\uff0c\u901a\u8fc7\u98df\u7ba1\u4e0e\u6c14\u7ba1\u4e4b\u95f4\u8005\u5360 15%\uff0c\u7ecf\u6c14\u7ba1\u524d\u8005\u5360 5%[9]<\/sup>\u3002\u672c\u4f8b\u60a3\u8005\u5c5e\u4e8e\u98df\u7ba1\u540e\u4f4d\u7684\u5f02\u5e38\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\uff0c\u5728\u5de6\u4e3b\u52a8\u8109\u5f13\u4e0e\u5f02\u5e38\u7684\u53f3\u9501\u9aa8\u4e0b\u52a8\u8109\u4e2d\u7537\u6027 25%\u3001\u5973\u6027 75%\uff0c\u800c\u5bf9\u53f3\u4e3b\u52a8\u8109\u5f13\u5f02\u5e38\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u7684\u7537\u6027\u5360 67%\u3001\u5973\u6027\u5360 33%[10]<\/sup>\u3002Kommerell \u61a9\u5ba4\u5e76\u53d1\u7834\u88c2\u7684\u6bd4\u7387\u5728 0\uff5e50%\uff0c\u5176\u4e2d\u7834\u88c2\u61a9\u5ba4\u7684\u5927\u5c0f\u4e3a 4\uff5e10 cm\uff0c\u7834\u88c2\u7387\u9ad8\u8fbe 19%[11]<\/sup>\u3002\u5176\u6b21\uff0c\u53f3\u5f13\u53f3\u964d\u5bfc\u81f4\u4e3b\u52a8\u8109\u5f13\u5f62\u6210\u7a79\u9876\u6837\u7ed3\u6784\uff0c\u5bfc\u81f4\u8840\u6d41\u5bf9\u4e3b\u52a8\u8109\u5f13\u76f4\u63a5\u51b2\u51fb\uff0c\u5bfc\u81f4\u60a3\u8005\u5bb9\u6613\u53d1\u751f\u5939\u5c42\u3002<\/p>\n

\n\t\t4.3   Kommerell \u61a9\u5ba4\u7684\u8bca\u65ad
\n\t<\/h3>\n

\u6587\u732e[12]<\/sup>\u62a5\u9053\uff0c\u5f53\u5f02\u4f4d\u9501\u9aa8\u4e0b\u52a8\u8109\u8d77\u59cb\u90e8\u81a8\u5927\u5904\u7684\u76f4\u5f84\u5927\u4e8e\u6b63\u5e38\u9501\u9aa8\u4e0b\u52a8\u8109\u76f4\u5f84\u7684 1.5 \u500d\u65f6\u624d\u8003\u8651\u8bca\u65ad\u4e3a Kommerell \u61a9\u5ba4\uff0c\u5982\u679c\u5c0f\u4e8e\u8fd9\u4e2a\u503c\u5219\u79f0\u4e3a\u8ff7\u8d70\u9501\u9aa8\u4e0b\u52a8\u8109\u3002\u4e34\u5e8a\u4e0a\u7684\u8f85\u52a9\u68c0\u67e5\u624b\u6bb5\u5305\u62ec\u8d85\u58f0[13]<\/sup>\u3001\u8840\u7ba1\u9020\u5f71\u3001CT \u53ca MRI\u3002\u8d85\u58f0\u64cd\u4f5c\u4fbf\u5229\uff0c\u4f46\u53d7\u6c14\u4f53\u5e72\u6270\u4e0d\u591f\u654f\u611f\uff0c\u4e3b\u8981\u7528\u4e8e\u660e\u786e\u6709\u65e0\u5408\u5e76\u5fc3\u810f\u7578\u5f62\uff1b\u8840\u7ba1\u9020\u5f71\u53ef\u660e\u786e\u8bca\u65ad\u4e3b\u52a8\u8109\u61a9\u5ba4\u5e76\u8fdb\u884c\u5206\u578b\uff0c\u4f46\u4e3a\u6709\u521b\u68c0\u67e5\uff0c\u64cd\u4f5c\u7e41\u7410\uff1bCT \u53ca MRI \u53ef\u4ee5\u4e3a\u8840\u7ba1\u7684\u89e3\u5256\u63d0\u4f9b\u4fe1\u606f\uff0c\u4f46\u662f MRI \u68c0\u67e5\u65f6\u95f4\u957f\uff0cCT \u68c0\u67e5\u662f\u8bca\u65ad\u672c\u75c5\u4e00\u79cd\u5feb\u901f\u4fbf\u6377\u7684\u68c0\u67e5\u65b9\u6cd5\u3002<\/p>\n

\n\t\t4.4   Kommerell \u61a9\u5ba4\u7684\u4e34\u5e8a\u8868\u73b0\u53ca\u624b\u672f\u6307\u5f81
\n\t<\/h3>\n

\u636e\u6587\u732e[14]<\/sup>\u62a5\u9053\uff0c\u5927\u7ea6 5% \u7684\u6210\u4eba\u4f34\u5f02\u5e38\u9501\u9aa8\u4e0b\u52a8\u8109\u60a3\u8005\u51fa\u73b0\u75c7\u72b6\u3002\u6210\u4eba\u60a3\u8005\u7684\u5e38\u89c1\u75c7\u72b6\u6709\u541e\u54bd\u56f0\u96be\u3001\u80f8\u75db\u6216\u4e0a\u80a2\u8840\u538b\u5dee\u5f02\uff0c\u7136\u800c\u547c\u5438\u9053\u75c7\u72b6\u5728\u513f\u7ae5\u60a3\u8005\u4e2d\u6bd4\u6210\u4eba\u66f4\u5e38\u89c1\uff0c\u56e0\u4e3a\u6ca1\u6709\u6c14\u7ba1\u50f5\u786c\u3002\u5bf9\u4e8e\u624b\u672f\u6307\u5f81\uff0c\u4e00\u822c\u8ba4\u4e3a\uff0c\u5f53\u61a9\u5ba4\u5b54\u76f4\u5f84\u8d85\u8fc7 30 mm\u3001\u4e0e\u61a9\u5ba4\u76f8\u90bb\u7684\u4e3b\u52a8\u8109\u76f4\u5f84\u8d85\u8fc7 50 mm\u3001\u6709\u4e25\u91cd\u7684\u538b\u8feb\u75c7\u72b6\u3001\u5939\u5c42\u5f62\u6210\u3001\u690e\u52a8\u8109\u8fd4\u6d41\u9885\u5185\u7f3a\u8840\u4e25\u91cd\u8005\u4e4b\u4e00\u8005\u901a\u5e38\u53ef\u4ee5\u8003\u8651\u624b\u672f\u5e72\u9884\u3002\u4e5f\u6709\u7814\u7a76\u8005[15]<\/sup>\u8ba4\u4e3a\uff0cKommerell \u61a9\u5ba4\u76f4\u5f84\u4e0e\u540c\u4fa7\u6b63\u5e38\u9501\u9aa8\u4e0b\u52a8\u8109\u76f4\u5f84\u4e4b\u6bd4\u4e3a 1.5\uff5e2.0 \u65f6\u9700\u8981\u5207\u9664\u3002\u624b\u672f\u7684\u5173\u952e\u662f\u89e3\u9664\u538b\u8feb\uff0c\u907f\u514d\u61a9\u5ba4\u7834\u88c2\u548c\u91cd\u5efa\u53d8\u5f02\u7684\u9501\u9aa8\u4e0b\u52a8\u8109\u3002<\/p>\n

\n\t\t4.5   Kommerell \u61a9\u5ba4\u7684\u6cbb\u7597
\n\t<\/h3>\n

\n\t\t4.5.1   \u5f00\u80f8\u624b\u672f
\n\t<\/h4>\n

\u6587\u732e[16]<\/sup>\u62a5\u9053\u7684\u7b2c 1 \u4f8b\u63a5\u53d7\u5916\u79d1\u6cbb\u7597\u7684\u60a3\u8005\u91c7\u7528\u7684\u5f00\u653e\u624b\u672f\uff0c\u901a\u8fc7\u7b80\u5355\u7ed3\u624e\u5f02\u5e38\u8840\u7ba1\u4ee5\u6cbb\u7597\u541e\u54bd\u56f0\u96be\u3002\u4f46\u5bf9\u4e8e\u6709\u5f02\u5e38\u9501\u9aa8\u4e0b\u52a8\u8109\u7684\u513f\u7ae5\uff0c\u5355\u7eaf\u7ed3\u624e\u5f88\u5c11\u4f1a\u5f15\u8d77\u7f3a\u8840\u6027\u5e76\u53d1\u75c7\uff0c\u4f46\u6210\u5e74\u60a3\u8005\u53ef\u80fd\u4f1a\u51fa\u73b0\u4e0a\u80a2\u7f3a\u8840\u6216\u9501\u9aa8\u4e0b\u76d7\u8840\u73b0\u8c61\u3002Esposito \u7b49[17]<\/sup>\u62a5\u9053\uff0c\u5728\u6ca1\u6709\u6062\u590d\u624b\u81c2\u8840\u6d41\u91cf\u7684\u60c5\u51b5\u4e0b\u63a5\u53d7\u6cbb\u7597\u7684\u60a3\u8005\u4e2d\u6709 64% \u51fa\u73b0\u660e\u663e\u7684\u7f3a\u8840\u6027\u5e76\u53d1\u75c7\uff0c\u5982\u76ae\u80a4\u6e29\u5ea6\u4f4e\u53ca\u9759\u606f\u75db\u3002\u56e0\u6b64\uff0c\u5728\u6210\u4eba\u4e2d\u82e5\u6709\u5fc5\u8981\uff0c\u5efa\u8bae\u91cd\u5efa\u5f02\u5e38\u52a8\u8109[18]<\/sup>\u3002\u9501\u9aa8\u4e0b\u52a8\u8109\u7684\u91cd\u5efa\u53ef\u901a\u8fc7\u5f00\u80f8\u539f\u4f4d\u91cd\u5efa\u3001\u9501\u9aa8\u4e0a\u548c\u9888\u90e8\u5207\u5f00\u884c\u9888\u52a8\u8109\u81f3\u9501\u9aa8\u4e0b\u52a8\u8109\u642d\u6865\u6216\u5c06\u5f02\u5e38\u52a8\u8109\u8f6c\u4f4d\u81f3\u9888\u52a8\u8109[10]<\/sup>\u3002\u5f00\u653e\u624b\u672f\u521b\u4f24\u5927\uff0c\u5e76\u53d1\u75c7\u591a\u3002\u56fd\u5185\u5218\u671d\u5175\u7b49[19]<\/sup>\u62a5\u9053\u4e86 1 \u4f8b\u60a3\u8005\u91c7\u7528\u5f00\u653e\u624b\u672f\u540e\u58f0\u97f3\u5636\u54d1\u53ca\u5de6\u4fa7\u58f0\u5e26\u9ebb\u75f9\u3002Barr \u7b49[18]<\/sup>\u603b\u7ed3 99 \u4f8b\u53f3\u4f4d\u4e3b\u52a8\u8109\u5f13\u7ecf\u8fc7\u4e86\u79ef\u6781\u7684\u5916\u79d1\u6cbb\u7597\uff0c\u672f\u540e\u6b7b\u4ea1 5 \u4f8b\uff0c\u5168\u4e3a\u5f00\u653e\u624b\u672f\u60a3\u8005\u3002\u4f46\u5982\u679c\u7ed3\u624e\u75c5\u53d8\u4fa7\u9501\u9aa8\u4e0b\u52a8\u8109\u8840\u538b\u4e0e\u5bf9\u4fa7\u80a2\u4f53\u8840\u538b\u65e0\u660e\u663e\u5dee\u522b\uff0c\u6216\u8005\u9501\u9aa8\u4e0b\u52a8\u8109\u76d7\u8840\u4e14\u540c\u4fa7\u690e\u52a8\u8109\u4e3a\u975e\u4f18\u52bf\u578b\uff0c\u4e5f\u53ef\u4e0d\u505a\u9501\u9aa8\u4e0b\u52a8\u8109\u7684\u91cd\u5efa\u3002\u603b\u4e4b\uff0c\u5f00\u80f8\u624b\u672f\u884c\u4e3b\u52a8\u8109\u61a9\u5ba4\u90e8\u5206\u5207\u9664\u4eba\u5de5\u8840\u7ba1\u66ff\u6362\u672f\uff0c\u8be5\u624b\u672f\u65b9\u5f0f\u53ef\u4ee5\u5207\u9664 Kommerell \u61a9\u5ba4\u53ca\u5468\u56f4\u7c98\u8fde\u7684\u7ea4\u7ef4\u7ed3\u7f14\u7ec4\u7ec7\u5c24\u5176\u662f\u6c14\u7ba1\u3001\u98df\u7ba1\u5468\u56f4\u7684\u7ea4\u7ef4\u7ec4\u7ec7\uff0c\u4ece\u800c\u89e3\u9664\u5bf9\u6c14\u7ba1\u98df\u7ba1\u7684\u538b\u8feb[20]<\/sup>\u3002\u5f00\u80f8\u624b\u672f\u7684\u7f3a\u70b9\u662f\uff0c\u624b\u672f\u9700\u8981\u4f53\u5916\u5faa\u73af\uff0c\u751a\u81f3\u662f\u6df1\u4f4e\u6e29\u4f53\u5faa\u73af\uff0c\u5904\u7406\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u6bd4\u8f83\u68d8\u624b[16, 21]<\/sup>\u3002\u53e6\u5916\uff0cKommerell \u61a9\u5ba4\u60a3\u8005\u901a\u5e38\u5589\u8fd4\u795e\u7ecf\u7684\u8d70\u5f62\u591a\u53d1\u751f\u53d8\u5f02\uff0c\u624b\u672f\u4e2d\u5f88\u5bb9\u6613\u635f\u4f24\u5589\u8fd4\u795e\u7ecf\uff0c\u5f71\u54cd\u60a3\u8005\u7684\u751f\u6d3b\u8d28\u91cf\u3002<\/p>\n

\n\t\t4.5.2   \u6742\u4ea4\u624b\u672f
\n\t<\/h4>\n

\u4e3a\u4e86\u51cf\u5c11 Kommerell \u61a9\u5ba4\u624b\u672f\u7684\u521b\u4f24\uff0c\u9488\u5bf9\u6b64\uff0c\u90e8\u5206\u5b66\u8005\u91c7\u53d6\u6742\u4ea4\u624b\u672f\u65b9\u6848\u3002\u6742\u4ea4\u624b\u672f\u4e00\u822c\u91c7\u53d6\u9888\u52a8\u8109-\u9501\u9aa8\u4e0b\u65c1\u8def-\u5e76\u7ed3\u624e\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109\u8fd1\u7aef\u4ee5\u9632\u6b62\u2161\u578b\u5185\u6f0f\u7684\u53d1\u751f\uff0c\u7136\u540e\u901a\u8fc7\u80a1\u52a8\u8109\u5165\u8def\u4e8e\u4e3b\u52a8\u8109\u5f13\u690d\u5165\u652f\u67b6[22]<\/sup>\u3002\u5728\u624b\u672f\u4e2d\u5c3d\u91cf\u8fdc\u79bb\u61a9\u5ba4\u5904\u8fdb\u884c\u8840\u7ba1\u543b\u5408\uff0c\u56e0\u4e3a\u61a9\u5ba4\u543b\u5408\u53e3\u6613\u7834\u788e\uff0c\u6e17\u8840\u660e\u663e\uff0c\u65e0\u6cd5\u4fee\u8865\uff0c\u8fd9\u4e00\u73b0\u8c61\u5728\u627f\u6587\u9f99\u7b49[23]<\/sup>\u7684\u7814\u7a76\u4e2d\u6709\u62a5\u9053\u3002<\/p>\n

\n\t\t4.5.3   \u8154\u5185\u6280\u672f
\n\t<\/h4>\n

\u968f\u7740\u8154\u5185\u6280\u672f\u7684\u4e0d\u65ad\u53d1\u5c55\u4e0e\u8fdb\u6b65\uff0c\u7531\u4e8e\u5176\u5fae\u521b\u6027\u4f18\u70b9\uff0c\u8d8a\u6765\u8d8a\u591a\u7684\u4e3b\u52a8\u8109\u75c5\u53d8\u91c7\u53d6\u8154\u5185\u6cbb\u7597[24]<\/sup>\uff0c\u80fd\u591f\u660e\u663e\u964d\u4f4e\u60a3\u8005\u7684\u81f4\u6b8b\u7387\u53ca\u75c5\u6b7b\u7387[25-26]<\/sup>\u3002\u5b8c\u5168\u8154\u5185\u6cbb\u7597\u5728\u53f3\u4f4d\u4e3b\u52a8\u8109\u5f13\u7684\u60a3\u8005\u6709\u8db3\u591f\u7684\u951a\u5b9a\u533a\uff0c\u5f02\u5e38\u7684\u9501\u9aa8\u4e0b\u52a8\u8109\u5728\u6ca1\u6709\u8840\u7ba1\u91cd\u5efa\u7684\u60c5\u51b5\u4e0b\u53ef\u8003\u8651\u5f39\u7c27\u5708\u6813\u585e\uff0c\u4e5f\u53ef\u5f00\u7a97\u6216\u70df\u56f1\u6cd5\u91cd\u5efa\u9501\u9aa8\u4e0b\u52a8\u8109\uff0c\u4f18\u52bf\u4fa7\u690e\u52a8\u8109\u9700\u8981\u91cd\u5efa\uff0c\u5426\u5219\u5bb9\u6613\u5bfc\u81f4\u8111\u6897\u7684\u53d1\u751f[27]<\/sup>\u3002\u7b2c 1 \u4f8b\u5b8c\u5168\u8154\u5185\u52a8\u8109\u4fee\u590d\u662f\u7531 Gafoor \u7b49[28]<\/sup>\u62a5\u9053\u7684\uff0c\u91c7\u7528\u5b9a\u5236\u652f\u67b6\uff0c\u5f00\u7a97\u884c\u9888\u52a8\u8109\u548c\u5f02\u5e38\u9501\u9aa8\u4e0b\u52a8\u8109\u91cd\u5efa\u3002\u76ee\u524d\u5b8c\u5168\u8154\u5185\u6cbb\u7597\u65e0\u6b7b\u4ea1\u75c5\u4f8b\u62a5\u9053\uff0c\u4f46\u56e0\u672a\u8fdb\u884c\u9501\u9aa8\u4e0b\u52a8\u8109\u91cd\u5efa\u53ef\u51fa\u73b0\u624b\u81c2\u8ddb\u884c\u548c\u2161\u578b\u5185\u6f0f\u3002\u7136\u800c\u8154\u5185\u6cbb\u7597\u5bf9\u60a3\u8005\u7684\u52a8\u8109\u89e3\u5256\u6709\u4e00\u5b9a\u7684\u8981\u6c42\uff0c\u4e3b\u52a8\u8109\u5f13\u53d8\u5f02\u589e\u52a0\u4e86\u8154\u5185\u4fee\u590d\u672f\u7684\u96be\u5ea6\u3002\u5bf9\u4e8e\u60a3\u8005\u7684\u53f3\u4f4d\u4e3b\u52a8\u8109\u5f13\u76f8\u8f83\u5de6\u4f4d\u5f13\u800c\u8a00\u4e3b\u52a8\u8109\u66f4\u52a0\u626d\u66f2\uff0c\u589e\u52a0\u4e86\u652f\u67b6\u4e0a\u884c\u7684\u96be\u5ea6\uff0c\u5e76\u4e14\u60a3\u8005\u4e3b\u52a8\u8109\u5206\u652f\u8840\u7ba1\u53d8\u5f02\uff0c\u53ef\u80fd\u5bfc\u81f4\u652f\u67b6\u8fd1\u7aef\u951a\u5b9a\u533a\u4e0d\u8db3\u3002\u4e3a\u4e86\u89e3\u51b3\u951a\u5b9a\u533a\u4e0d\u8db3\u7684\u95ee\u9898\uff0c\u76ee\u524d\u8154\u5185\u5e94\u7528\u6700\u591a\u7684\u5c31\u662f\u70df\u56f1\u6280\u672f\u53ca\u5f00\u7a97\u6280\u672f\u3002\u6700\u8fd1 Sun \u7b49[29]<\/sup>\u91c7\u7528 3D \u6253\u5370\u6280\u672f\u8f85\u52a9\u6cbb\u7597\u53d6\u5f97\u5f88\u597d\u6548\u679c\u3002\u8154\u5185\u6cbb\u7597\u867d\u7136\u907f\u514d\u4e86\u5f00\u80f8\uff0c\u4f46\u5bf9\u4e8e\u6709\u98df\u7ba1\u548c\u6c14\u7ba1\u538b\u8feb\u7684\u60a3\u8005\uff0c\u65e0\u6cd5\u7f13\u89e3\u60a3\u8005\u6897\u963b\u7684\u75c7\u72b6\u3002\u8154\u5185\u7531\u4e8e\u7f3a\u4e4f\u957f\u671f\u7684\u6cbb\u7597\u7ed3\u679c\uff0c\u4f46\u5bf9\u4e8e\u4f53\u5f31\u7684\u60a3\u8005\u6216\u662f\u65e0\u660e\u663e\u538b\u8feb\u75c7\u72b6\u7684\u60a3\u8005\u5e94\u8be5\u4f18\u5148\u8003\u8651\u8840\u7ba1\u8154\u5185\u6cbb\u7597\uff0c\u5c24\u5176\u9002\u7528\u4e8e\u61a9\u5ba4\u7834\u88c2\u7684\u62a2\u6551\u3002\u9501\u9aa8\u4e0b\u52a8\u8109\u72ed\u7a84\u5f71\u54cd\u4e0a\u80a2\u8840\u4f9b\u53ca\u690e\u52a8\u8109\u9885\u5185\u8840\u4f9b\uff0c\u9700\u8c28\u614e\u5bf9\u5f85\u3002\u672c\u75c5\u4f8b\u4f34\u9501\u9aa8\u4e0b\u52a8\u8109\u5f00\u53e3\u91cd\u5ea6\u72ed\u7a84\uff0c\u672f\u524d\u68c0\u67e5\u63d0\u793a\u8840\u6db2\u5012\u6d41\u4e14\u60a3\u8005\u672f\u524d\u65e0\u4e0a\u80a2\u548c\u540e\u5faa\u73af\u7f3a\u8840\u75c7\u72b6\uff0c\u4e0d\u5b58\u5728\u4e0a\u80a2\u53ca\u9885\u5185\u7f3a\u8840\u95ee\u9898\u53ca\u662f\u5426\u9700\u8981\u6062\u590d\u690e\u52a8\u8109\u6b63\u5411\u8840\u6d41\u7684\u95ee\u9898\uff0c\u56e0\u6b64\uff0c\u8ba4\u4e3a\u60a3\u8005\u4e0d\u5b58\u5728\u540e\u5faa\u73af\u7f3a\u8840\u53ca\u4e0a\u80a2\u7f3a\u8840\u75c7\u72b6\u7684\u60c5\u51b5\u4e0b\u53ef\u5c01\u95ed\u9501\u9aa8\u4e0b\u52a8\u8109\uff0c\u7ed3\u679c\u60a3\u8005\u672f\u540e\u672a\u53d1\u751f\u540e\u5faa\u73af\u53ca\u4e0a\u80a2\u7f3a\u8840\u6539\u53d8\u3002<\/p>\n

\u603b\u4e4b\uff0c\u60a3\u8005\u624b\u672f\u7684\u5b89\u5168\u5f97\u76ca\u4e8e\u672f\u524d\u7684\u5145\u5206\u8bc4\u4f30\uff0c\u8d85\u58f0\u3001CT \u8840\u7ba1\u9020\u5f71\u3001\u78c1\u5171\u632f\u53ca\u6570\u5b57\u51cf\u5f71\u8840\u7ba1\u9020\u5f71\u5747\u6709\u4e00\u5b9a\u7684\u4f18\u52bf\uff0c\u4f46\u4e5f\u6709\u4e0d\u8db3\uff0c\u5c06\u8fd9\u4e9b\u5f71\u50cf\u76f8\u4e92\u7ed3\u5408\uff0c\u4e92\u76f8\u8865\u5145\uff0c\u51c6\u786e\u8bc4\u4f30\u53d8\u5f02\u8840\u7ba1\u7684\u8d77\u6e90\u53ca\u8d70\u5411\uff0c\u4ee5\u4fbf\u9009\u62e9\u66f4\u597d\u7684\u6cbb\u7597\u65b9\u6848\u3002\u901a\u8fc7\u5f71\u50cf\u5b66\u8981\u5145\u5206\u8bc4\u4f30\u4e3b\u52a8\u8109\u5f13\u5f62\u3001\u951a\u5b9a\u533a\u957f\u5ea6\u3001\u4e0a\u80a2\u53ca\u5934\u90e8\u8840\u4f9b\u60c5\u51b5\u3002\u53f3\u4f4d\u4e3b\u52a8\u8109\u5408\u5e76\u8ff7\u8d70\u5de6\u9501\u9aa8\u4e0b\u52a8\u8109 Kommerell \u61a9\u5ba4\u8f83\u7f55\u89c1\uff0c\u4f20\u7edf\u624b\u672f\u75c5\u6b7b\u7387\u8f83\u9ad8\u4e14\u5bf9\u60a3\u8005\u635f\u4f24\u5927\uff0c\u91c7\u7528\u8154\u5185\u4fee\u590d\u672f\uff0c\u521b\u4f24\u5c0f\uff0c\u6062\u590d\u5feb\uff0c\u662f\u4e00\u79cd\u8f83\u597d\u7684\u672f\u5f0f\u9009\u62e9\u3002\u5b8c\u5168\u8154\u5185\u4fee\u590d\u624b\u672f\u6cbb\u7597\u8be5\u79cd\u75c5\u4f8b\u6587\u732e\u62a5\u9053\u8f83\u5c11[14]<\/sup>\uff0c\u76ee\u524d\u5927\u5bb6\u63a5\u89e6\u7684\u75c5\u4f8b\u6570\u76ee\u5c1a\u4e0d\u8db3\uff0c\u6cbb\u7597\u7ecf\u9a8c\u8fd8\u9700\u8981\u8fdb\u4e00\u6b65\u79ef\u7d2f\uff0c\u867d\u7136\u6709\u7814\u7a76\u8005[30]<\/sup>\u62a5\u9053\u4e2d\u671f\u7597\u6548\u663e\u8457\uff0c\u4f46\u75c5\u4f8b\u6570\u6709\u9650\uff0c\u8fdc\u671f\u7597\u6548\u6709\u5f85\u4e8e\u8fdb\u4e00\u6b65\u89c2\u5bdf\u968f\u8bbf\u3002\u603b\u4e4b Kommerell s \u61a9\u5ba4\u7684\u6cbb\u7597\u7b56\u7565\u7684\u9009\u62e9\u5e94\u57fa\u4e8e\u60a3\u8005\u7684\u89e3\u5256\u3001\u8010\u53d7\u60c5\u51b5\u548c\u5916\u79d1\u4e13\u4e1a\u77e5\u8bc6\u800c\u5b9a\u3002<\/p>\n

\u91cd\u8981\u58f0\u660e<\/p>\n

\u5229\u76ca\u51b2\u7a81\u58f0\u660e\uff1a\u672c\u6587\u5168\u4f53\u4f5c\u8005\u9605\u8bfb\u5e76\u7406\u89e3\u4e86\u4e2d\u56fd\u666e\u5916\u57fa\u7840\u4e0e\u4e34\u5e8a\u6742\u5fd7\u7684\u653f\u7b56\u58f0\u660e\uff0c\u6211\u4eec\u6ca1\u6709\u76f8\u4e92\u7ade\u4e89\u7684\u5229\u76ca\u3002<\/p>\n

\u4f5c\u8005\u8d21\u732e\u58f0\u660e\uff1a\u5218\u4e00\u4eba\u548c\u5f90\u5146\u660e\u64b0\u5199\u6587\u7ae0\uff0c\u9f50\u4e00\u4fa0\u3001\u5d14\u4e16\u519b\u548c\u90ed\u8fde\u745e\u76f8\u5173\u6587\u732e\u67e5\u8be2\uff0c\u9f50\u7acb\u884c\u548c\u4f5f\u94f8\u8fdb\u884c\u56fe\u7247\u5904\u7406\uff0c\u90ed\u5efa\u660e\u534f\u52a9\u683c\u5f0f\u7f16\u8f91\uff0c\u8c37\u6d8c\u6cc9\u6307\u5bfc\u6587\u7ae0\u5199\u4f5c\u3002<\/p>\n

\u4f26\u7406\u58f0\u660e\uff1a\u8be5\u7814\u7a76\u5df2\u901a\u8fc7\u9996\u90fd\u533b\u79d1\u5927\u5b66\u5ba3\u6b66\u533b\u9662\u7684\u4f26\u7406\u5ba1\u6838\u6279\u51c6\u3002<\/p>\n

\u5fd7\u8c22\u3000\u611f\u8c22\u6240\u6709\u4e3a\u672c\u6587\u7684\u6210\u7a3f\u505a\u51fa\u8d21\u732e\u7684\u533b\u751f\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"

Kommerell \u61a9\u5ba4\u662f\u5148\u5929\u6027\u75be\u75c5\uff0c\u4e8e 1936 \u5e74\u7531\u5fb7\u56fd\u7684 Burckhar … \u7ee7\u7eed\u9605\u8bfb →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[70],"tags":[],"class_list":["post-38694","post","type-post","status-publish","format-standard","hentry","category-70"],"_links":{"self":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/38694","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=38694"}],"version-history":[{"count":0,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/38694\/revisions"}],"wp:attachment":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=38694"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=38694"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=38694"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}