交感干臂丛间灰、白交通支的解剖学特点及其临床意义  

Anatomic features and clinical significance of the rami communicans

作　　者：宋占锋[1,2] 陆志方[1] 夏春林[1] 蔡杰[1] 邢卫星[1] 

机构地区：[1]苏州大学医学部博习临床解剖研究所暨解剖学教研室,江苏苏州215123 [2]邢台矿业集团总医院,河北邢台054000

出　　处：《中国临床解剖学杂志》2009年第1期24-27,共4页Chinese Journal of Clinical Anatomy

基　　金：江苏省卫生厅重大科研项目(H200515)

摘　　要：目的:探讨交感干臂丛间交通支的分布特点及其临床意义。方法:选用33具成年防腐尸体,解剖并观测交感干与臂丛交通支的走行分布特点。结果:1.颈中神经节或节间支与臂丛交通支多对称分布,至第5、6颈神经的42条交通支在第5、6颈椎横突水平内行自头长肌、颈长肌间沟后行入神经。2.星状神经节(或颈下神经节及胸1神经节)发出向内上方加入第7、8颈神经的交通支除1例外均对称分布。至C8神经的交通支与C8神经结合前51侧发出分支与C7神经相交通,其中45侧穿过第7颈椎横突孔。至C7神经的交通支与C7神经结合前41侧发出分支与C6神经相交通,分支伴椎动脉经第6颈椎横突孔上行,29侧分支沿途发出许多细小纤维支至椎动脉及周围椎间、横突间关节。结论:1、交感干与臂丛间的交通支具有典型的分布特点,可为研究交感神经对臂丛神经功能支配及颈椎前路扩大减压术时减少损伤提供解剖学资料。2、至C7神经的交通支分布特点可为临床上通过椎神经阻滞治疗顽固性颈痛提供解剖学依据。Objective： To explore anatomic features and clinical significance of the rami communicans between cervical sympathetic trunk （CST） and brachial plexus （BP）. Methods： 33 antiseptic cadavers were dissected bilaterally to observe the anatomic characteristics of rami communicans between CST and BP. Results：（1） Most of the rami eommunicans between middle cervical ganglion or interganglionie rami and BP distributed symmetrically. 42 rami distributed to C5 or C6 spinal nerves run medially firstly at the level of the transverse process of C5 or C6, passed through the groove between longns scapitis and colli, and then entered C5 or C6 spinal nerves. （2） Except for 1 case, all the medial rami communicans between the eervicothoracic ganglion （CTG） and C7, C8 spinal nerves were symmetrical. Before joining C8 spinal nerve, 51 sides of rami from CTG to Cs spinal nerve sent out branches communicating with C7 spinal nerve, 45 sides of which ascended through the C7 transverse foramina. Before joining C7, 41 sides of rami from CTG to C7 sent out branches ascending posteromedially to the vertebral artery （VA） and C6 spinal nerve, while some tiny branches can be seen in 29 sides of rami between VA and the fibrous capsule of adjacent zygapophyseal and intervertebral joints. Conclusions： （1） Typical anatomic distribution of the rami communicans between CST and BP are useful for studying the innervations of sympathetic nerve and providing clinic references for extensive decompression during anterior cervical approach. （2） The rami communicans to C7 spinal nerve maybe concerned with refractory neck pain, which should be considered in nerve block treatment process.

关 键 词：交感干 臂丛 交通支 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]