利用神经入肌点和肌内神经密集区中心定位成人背阔肌痉挛的阻滞靶点  

Using nerve entry point and intramuscular nerve dense region center for positioning block target spot of adult latissimus dorsi muscle spasticity

作　　者：赖柏安 唐少华 杨胜波 LAI Baian;TANG Shaohua;YANG Shengbo(Department of Anatomy,Zunyi Medical University,Zunyi,Guizhou 563099,China)

机构地区：[1]遵义医科大学人体解剖学教研室,贵州遵义563099

出　　处：《重庆医学》2019年第5期770-774,共5页Chongqing medicine

基　　金：国家自然科学基金资助项目(31540031;31660294)

摘　　要：目的准确定位背阔肌神经入肌点(NEP)和肌内神经密集区中心(CINDR)的位置。方法将12具成人尸体颈静脉切迹至剑胸接合处,腋前线至腋后线之间的体表曲线分别设为NEP的纵向参考线(L1)和横向参考线(H1);肩胛冈内、外侧端间的体表曲线为CINDR的横向参考线(H2),通过CINDR体表投影点连接H2与髂嵴之间的曲线为CINDR的纵向参考线(L2)。Sihler′s染色显示CINDR。硫酸钡标记NEP和CINDR,CT扫描。结果经过NEP的体表投影点的垂线和水平线分别相交于H1和L1的(74.01±3.43)%和(30.41±3.19)%处,NEP深度为(1.28±0.35)cm;背阔肌有2个CINDR,分别投影于H2的(57.50±3.16)%和(15.03±2.76)%、L2的(36.68±3.14)%和(47.89±2.88)%处,深度分别为(1.91±0.38)和(1.85±0.41)cm。结论界定的这些位置应为背阔肌痉挛肌内和肌外神经阻滞术的最佳靶点部位。Objective To accurately position the location of the nerve entry point(NEP)and intramuscular nerve dense region(CINDR)center of latissimus dorsi muscle.Methods In 12 adult cadavers,the body surface curved lines between the jugular notch and the junction of sternal body and xiphoid process,and the anterior axillary line and the posterior axillary line were designated as the longitudinal reference line(L 1)and the horizontal reference line(H 1)of NEP,respectively.The body surface curved line between the medial and the lateral end of the mesoscapula was designated as the horizontal reference line(H 2)of CINDR,and the curved line joining H 2 line and crista iliaca was designated as the longitudinal reference line(L 2)through the body surface projection point of the CINDR.CINDR was showed by the Sihler′s staining,NEP and CINDR were labeled with barium sulfate and scanned with spiral computed tomography(CT).Results The vertical and horizontal lines through the body surface projection point of NEP were intersected at(74.01±3.43)%of H 1 line and(30.41±0.38)%of L 1 line,respectively,the NEP depth was(1.28±0.35)cm;there were 2 CINDRs in the latissimus dorsi,which had projections at(57.50±3.16)%and(15.03±2.76)%of H 2 line,and at(36.68±3.14)%and(47.89±2.88)%of L 2 line,the depths were(1.91±3.19)cm and(1.85±0.41)cm,respectively.Conclusion These defined locations should be the optimal target spot sites for intramuscular and extramuscular nerve block of latissimus dorsi muscle spasticity.

关 键 词：背阔肌 肌痉挛 神经入肌点 肌内神经密集区中心 靶点定位 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]