束支

束支
束支
	左束支（4）和右束支（10）
	《解剖學術語》 [在维基数据上编辑]

束支（英語：Bundle branches）是心脏传导系统中将电冲动从希氏束传递至心室的浦肯野纤维的关键结构，属于希氏束的分支^[1]。

解剖

希氏束在室间隔中分为两个主干^[2]：

左束支：沿室间隔左侧下行，进一步分为左前支与左后支
右束支：沿室间隔右侧走行

这些分支最终延伸为细密的浦肯野纤维网络，共同完成心室肌的电冲动传导^[2]。

临床意义

束支或其分支因心肌梗死、心脏手术或基础心脏病受损时，可导致心室去极化路径异常，称为束支传导阻滞^[3]。

历史

束支结构最早于1904年被正式描述，但其生理功能直至1906年田原淳系统阐述了哺乳动物的心脏传导系统后才得以明确^[4]。1910年，Hans Eppinger与Carl Julius Rothberger通过实验证实了，切断双侧的束支可导致完全性的心脏传导阻滞，从而为束支的电传导功能提供了直接证据^[5]。

参考资料

^ Kullmann, Tamás; Baráth, Zoltán; Csiszér, Eszter. Remission of left Tawara-branch block under treatment for systemic sarcoidosis. International Journal of Cardiology. 2009-01-09, 131 (2) [2025-12-02]. ISSN 0167-5273. PMID 17935802. doi:10.1016/j.ijcard.2007.07.063 （英语）.
^ ^2.0 ^2.1 Tusscher, K. H. W. J. Ten; Panfilov, A. V. Modelling of the ventricular conduction system. Progress in Biophysics and Molecular Biology. Cardiovascular Physiome. 2008-01-01, 96 (1) [2025-12-02]. ISSN 0079-6107. doi:10.1016/j.pbiomolbio.2007.07.026.
^ Kumar, Vineet; Venkataraman, Rajesh; Aljaroudi, Wael; Osorio, Jose; Heo, Jaekyeong; Iskandrian, Ami E.; Hage, Fadi G. Implications of Left Bundle Branch Block in Patient Treatment. American Journal of Cardiology. 2013-01-15, 111 (2) [2025-12-02]. ISSN 0002-9149. PMID 23111137. doi:10.1016/j.amjcard.2012.09.029 （英语）.
^ Silverman, Mark E.; Grove, Daniel; Upshaw, Charles B. Why Does the Heart Beat?. Circulation. 2006-06-13, 113 (23) [2025-12-02]. doi:10.1161/CIRCULATIONAHA.106.616771.
^ Hollman, Arthur. The history of bundle branch block. Medical History. 1985-01, 29 (S5) [2025-12-02]. ISSN 2048-8343. PMC 2557404 . PMID 3915526. doi:10.1017/S0025727300070538 （英语）.

延伸阅读

Massing GK, James TN. Anatomical configuration of the His bundle and bundle branches in the human heart. Circulation. April 1976, 53 (4): 609–21. PMID 1253382. doi:10.1161/01.CIR.53.4.609 .

Widran J, Lev M. The dissection of the atrioventricular node, bundle and bundle branches in the human heart. Circulation. December 1951, 4 (6): 863–7. PMID 14879494. doi:10.1161/01.CIR.4.6.863 

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[1] Kullmann, Tamás; Baráth, Zoltán; Csiszér, Eszter. Remission of left Tawara-branch block under treatment for systemic sarcoidosis. International Journal of Cardiology. 2009-01-09, 131 (2) [2025-12-02]. ISSN 0167-5273. PMID 17935802. doi:10.1016/j.ijcard.2007.07.063 （英语）.

[:0-2] 2.0 ^2.1 Tusscher, K. H. W. J. Ten; Panfilov, A. V. Modelling of the ventricular conduction system. Progress in Biophysics and Molecular Biology. Cardiovascular Physiome. 2008-01-01, 96 (1) [2025-12-02]. ISSN 0079-6107. doi:10.1016/j.pbiomolbio.2007.07.026.

[3] Kumar, Vineet; Venkataraman, Rajesh; Aljaroudi, Wael; Osorio, Jose; Heo, Jaekyeong; Iskandrian, Ami E.; Hage, Fadi G. Implications of Left Bundle Branch Block in Patient Treatment. American Journal of Cardiology. 2013-01-15, 111 (2) [2025-12-02]. ISSN 0002-9149. PMID 23111137. doi:10.1016/j.amjcard.2012.09.029 （英语）.

[4] Silverman, Mark E.; Grove, Daniel; Upshaw, Charles B. Why Does the Heart Beat?. Circulation. 2006-06-13, 113 (23) [2025-12-02]. doi:10.1161/CIRCULATIONAHA.106.616771.

[5] Hollman, Arthur. The history of bundle branch block. Medical History. 1985-01, 29 (S5) [2025-12-02]. ISSN 2048-8343. PMC 2557404 . PMID 3915526. doi:10.1017/S0025727300070538 （英语）.

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