成人大圆肌肌内神经密集区中心的定位及在肌痉挛阻滞中的意义  

Localization of the centers of intramuscular nerve dense regions of the adult teres major muscle and its significance in blocking spasticity

作　　者：罗怀香 季松岭 杨胜波 Luo Huaixiang;Ji Songling;Yang Shengbo(Department of Anatomy,Zunyi Medical University,Zunyi 563000,China)

机构地区：[1]遵义医科大学人体解剖学教研室,贵州遵义563000

出　　处：《中国临床解剖学杂志》2021年第4期392-395,共4页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金(31660294);遵义医科大学硕士启动基金(F-761)。

摘　　要：目的确定大圆肌肌内神经密集区中心(centers of intramuscular nerve dense regions,CINDR)的位置和标记方法。方法选取24具成人尸体。设计紧贴皮肤连接肩胛上角和肩峰及肩胛下角的曲线分别为横向(H)和纵向(L)参考线。改良的Sihler’s染色法显示一侧大圆肌肌内神经密集区,解剖暴露另一侧肌的肌内神经密集区相应位置,硫酸钡标记其CINDR,螺旋CT扫描确定CINDR在背部和胸部的体表投影点(P和P'点)。Syngo系统确定通过P点的垂线分别与H和L线的交点(P_(H)和PL点)的位置和CINDR的深度。结果大圆肌内仅有1个肌内神经密集区,其CINDR的P_(H)位于H线的(86.71±0.85)%处,PL位于L线的(72.07±1.08)%处。CINDR的深度位于P-P'线的(40.06±2.44)%处。结论这些结果可作为肌内注射肉毒毒素A阻滞大圆肌痉挛的指导依据。Objective To localize the centers of intramuscular nerve dense region(CINDR)of teres major muscle accurately.Methods Twenty-four adult cadavers were collected.The curved lines close to skin surface connecting the superior angle of scapula and the acromion,and the inferior angle of scapula were designed as the horizontal(H)and longitudinal(L)reference lines,respectively.A modified Sihler's staining was used to show the intramuscular nerve dense region of one side teres major muscle.The corresponding position of the intramuscular nerve dense region of the other side muscle was anatomically exposed.And the CINDR was labeled with barium sulfate,and its body surface projection points(P and P')of CINDR on the back and chest were determined by spiral computed tomograP_(H)y.The position of intersections(P_(H) and PL)of point P vertical with H and L lines,and the depth of CINDR were determined by the Syngo system.Results There was only one intramuscular nerve dense region in teres major muscle.The P_(H) of CINDR was located at(86.71±0.85)%of line H and the PL was at(72.07±1.08)%of line L.The depth of CINDR was at(40.06±2.44)%of line P-P'.Conclusions These results should be used as a guidance for intramuscular injection of botulinum toxin A to block the spasticity of teres major muscle.

关 键 词：大圆肌 肌痉挛 肌内神经密集区 定位 

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