内脏大神经切断术的应用解剖  

Applied anatomy of greater splanchnic nerve

作　　者：蔡昌平[1] 

机构地区：[1]川北医学院解剖学教研室,四川南充637007

出　　处：《中国临床解剖学杂志》2005年第4期375-377,共3页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金资助项目(30370436)

摘　　要：目的:为内脏大神经切断术提供形态学基础。方法:对144侧内脏大神经进行解剖,观察其起止、行程和分支;测量其长度、直径和分支起点距腹腔神经节的距离以及在主动脉裂孔处内脏大神经距主动脉侧缘的距离。结果:94.4%的内脏大神经由来T5￣10交感神经节的纤维,4.2%的上界纤维起自T4交感神经节,1.4%的下界纤维起自T11交感神经节。内脏大神经长度为(49.3±20.49)mm,直径为(2.47±0.7)mm,在主动脉裂孔处左内脏大神经距主动脉左缘(3.01±2.94)mm,右内脏大神经距主动脉右缘(11.12±5.67)mm,在其行程过程中有35.4%的内脏大神经发出1￣3条分支。结论:在进行左内脏大神经切断术前,应先在CT或MRI下观察腹腔神经节的形状,根据其形状判断是否进行手术切断内脏大神经,术中在主动脉裂孔处腹主动脉左缘能寻找到大部分左内脏大神经,若不能找到,可在腹腔神经节外侧端背面寻找。Objective: To provide morphological information for splanchnicectomy. Methods: Anatomic study of greater splanchnic nerve on 144 sides of cadavers was performed. Its starting and stopping point,courses and branches were observed, as well as its length, diameter, the starting point of branches from celiac ganglia and the distance of greater splanchnic nerve from the left edge to the right edge at the site of the aortic hiatus were measured. Results: 94.4% of greater splanchnic nerves were formed by fibers coming from T5~10 sympathetic ganglia fiber; 4.2% from T4 sympathetic ganglia; 1.4% from T11 sympathetic ganglia. The length of greater splanchnic nerve was (49.3±20.49) mm, its diameter was (2.47±0.7) mm. At the site of aortic hiatus, the distance from the left greater splanchnic nerve to the left edge of aorta was about (3.01±2.94)mm, the distance from the right greater splanchnic nerve to the right edge of aorta was about (11.12±5.67)mm. 35.4% greater splanchnic nerves had 1~3 branches. Conclusions: Before performing left splanchnicectomy, the shape of celiac ganglia should be observed by CT or MRI. That can be decided whether to perform splanchnicectomy according to its shape. During the operation, majorities of left greater splanchnic nerve can be found at the left edge of aortic hiatus,otherwise, it can be found in posterior of its lateral part.

关 键 词：内脏大神经 内脏大神经切断术 胰腺癌 

分 类 号：R323.3[医药卫生—人体解剖和组织胚胎学] R322.85[医药卫生—基础医学]