臂丛颈部的解剖学研究及其临床应用  

The Anatomic Study of Brachial Plexus for the Cervical Part and its Clinical Supply

作　　者：丁家明[1] 佘永华[1] 冉茂成[1] 弋文[2] 彭素英[2] 张建[2] 李艳[2] 

机构地区：[1]川北医学院解剖学教研室 [2]川北医学院医学系,2004级本科学生四川南充637000

出　　处：《川北医学院学报》2006年第3期218-219,共2页Journal of North Sichuan Medical College

基　　金：四川省教育厅高等教育教学改革工程人才培养质量和教学改革项目(川教[2005]253号)

摘　　要：目的为臂丛麻醉提供解剖学基础,并为解剖学积累新资料。方法解剖成年国人尸体20具(男16,女4)、40侧颈部。观察第5-8颈神经前支(C5-8)和第1胸神经前支(T1)及其上、中、下干的位置。测量各根、干的长度和中干末端与锁骨相交点的距离以及中干末端与锁骨相交点距胸锁关节外侧的距离。结果C5,C6,C7(即臂丛中干),C8和T1的长度分别为(33.6±0.82)mm,(均数±标准差,下同),(28.6±0.73)mm,(53.4±1.15)mm,(28.7±1.24)mm和(24.2±1.11)mm。臂丛上、下干的长度分别为(25.9±0.78)mm和(32.7mm±1.28)mm。中干(即C7)末端与锁骨相交点的距离为(26.3±0.66)mm,中干末端与锁骨相交点距胸锁关节的距离为(59.3±1.04)mm。前斜角肌的止点均平锁骨上缘(100%),其止点外缘距离胸锁关节(46.2±0.8)mm。结论臂丛颈部阻滞的最佳穿刺点位于胸锁关节沿锁骨外侧60mm、直上26mm处。Objective To provide anatomical basis for anesthesia of the brachial plexus and new anatomical data for anatomy. Methods The cervical regions were dissected in 20 adults＇ Chinese cadaver specimen （16men,4 women） , 40 sides. The location and lengths of the roots of the C5, C6, CT（in the middle trunk）, C8 and TI, and the superior, middle （that is C7 ）, inferior trunks were observed and measured. The distances from the end of the middle trunks to the clavicle, and this point to the sternoclarvicular joints were measured. Results The lengths of the roots of C5, C6, C7 （ in the middle trunk） , C8 and T1 were （33.6 ± 0.82）mm（ average ± standard deviation）, （28.6 ± 0.73 ） mm, （ 53.4 ± 1.15 ） mm, （ 28.7 ± 1.24 ） mm and （ 24.2 ± 1.11 ） mm, respectively. The lengths of the superior and the inferior trunks of brachial plexus were （25.9 ± 0.78） ram and （32.7 ± 1.28） mm, respectively. The distances from the end of the middle trunks to the clavicles were （26.3 ± 0.66 ） mm, and from this points to the sternoclarvicular joints were （59.3 ± 1.04 ） mm. The distances from the insertion of the anterior scalene muscles to the sternoclarvicular joints are（42.6 ± 0.8mm）. Conclusion The best puncture point for anesthesia of the brachial plexus is located at the lateral sides of sternoclarvicular joints 60mm, from this points 26 mm superiorly.

关 键 词：臂丛 解剖学 麻醉学 

分 类 号：R323.4[医药卫生—人体解剖和组织胚胎学]