头臂干与气管的位置关系及其临床意义  

Anatomical relationship between the brachiocephalic trunk and the trachea and the clinical implications

作　　者：赵健[1] 王如雪 聂泽银 吴锋[1] 李雯娟 李晨妤 李怀斌[1] ZHAO Jian;WANG Ruxue;NIE Zeyin;WU Feng;LI Wenjuan;LI Chenyu;LI Huaibin(Department of Human Anatomy,Wannan Medical College,Wuhu 241002,China;Graduate School,Wannan Medical College,Wuhu 241002,China)

机构地区：[1]皖南医学院人体解剖学教研室,安徽芜湖241002 [2]皖南医学院研究生学院,安徽芜湖241002

出　　处：《南方医科大学学报》2023年第6期970-974,共5页Journal of Southern Medical University

基　　金：安徽省高等学校省级质量工程项目(2019jxtd072);安徽省高等学校省级质量工程项目(2020jyxm2096);皖南医学院高等教育教学改革研究项目(2021jyxm11);皖南医学院横向课题(H202004);皖南医学院一流课程培育项目(2020hhjk005)。

摘　　要：目的观察头臂干与气管的解剖形态和位置关系,为机械性呼吸道阻塞的诊疗和临床气管切开术提供解剖学基础。方法福尔马林固定后的成年男性标本70例,女性标本21例。自颈部至胸部分离并暴露喉部和气管全长,分离主动脉弓及其三个分支,显露头臂干与气管的解剖位置关系,并测量相关解剖学数值。结果头臂干与气管的位置关系中,不交叉型占3.30%,不完全交叉型占71.43%,完全交叉型占25.27%。男性标本的主动脉弓、头臂干和气管的外径及气管长度均较女性粗大(P<0.05),而主动脉弓和头臂干与环状软骨间的距离无明显性别差异(P>0.05)。头臂干上方的气管软骨环数量最少仅3个,最多可达10个,男女两组的均数无差异(P>0.05)。结论头臂干与气管的位置关系复杂,在机械性呼吸道阻塞的诊疗和气管切开术时,需注意预防头臂干和主动脉弓的损伤。Objective To observe the anatomical features and relative position of the brachiocephalic trunk and the trachea to provide an anatomical basis for diagnosis and treatment of mechanical airway obstruction and for facilitating the performance of tracheotomy.Methods A total of 91 formalin-fixed adult cadavers(70 male and 21 female)were used in this study.The whole length of the larynx and the trachea were separated and exposed from the neck to the chest,followed by separation of the aortic arch and its 3 branches to observe the anatomical position of the brachiocephalic trunk and the trachea.Results The brachiocephalic trunk and the trachea did not intersect in 3.30%,partially intersected in 71.43%,and completely intersected in 25.27%of the 91 cadaveric specimens.The male specimens all showed greater outer diameter of the aortic arch,the brachiocephalic trunk and the trachea with a greater length of the trachea than the female specimens(P<0.05),while the distances from the aortic arch to the brachiocephalic trunk or the cricoid cartilage did not differ significantly between them(P>0.05).The number of the tracheal cartilage rings above the brachiocephalic trunk ranged from 3 to 10,and the mean number did not differ significantly between the male and female specimens(P>0.05).Conclusion The brachiocephalic trunk has complex anatomical relationship with the trachea,and caution should be taken to avoid injuries of the brachiocephalic trunk and the aortic arch in the diagnosis and treatment of mechanical respiratory obstruction and during tracheotomy.

关 键 词：头臂干 气管 解剖学 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]