椎神经节麻醉的应用解剖学研究  

Applied anatomical study of anesthesia in vertebral ganglia

作　　者：吴文斌[1] 胡雨田 代琳曦 吕旺轩 吕丰均 尹袁杰 杨红梦 畅君达 李文奇[1] 郭义威[4] Wu Wenbin;Hu Yutian;Dai Linxi;Lv Wangxuan;Lv Fengjun;Yin Yuanjie;Yang Hongmeng;Chang Junda;Li Wenqi;Guo Yiwei(Human Anatomy Laboratory,Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Xinxiang Medical University,Xinxiang 453003,Henan Province,China;International Education School,Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Department of Human Anatomy,Histology and Embryology,Xinxiang Medical University,Xinxiang 453003,Henan Province,China)

机构地区：[1]新乡医学院大体形态学实验室 [2]新乡医学院 [3]新乡医学院国际教育学院 [4]新乡医学院人体解剖与组织胚胎学系,河南新乡453003

出　　处：《中国临床解剖学杂志》2023年第6期640-646,共7页Chinese Journal of Clinical Anatomy

基　　金：河南省教育科学规划一般课题(2021YB0158)。

摘　　要：目的观测椎神经节的解剖特征,为临床颈部交感干神经节麻醉提供解剖学依据。方法对30具(60侧)成人大体标本进行解剖,根据出现的形式区分颈中神经节与椎神经节,观测椎神经节的形态、位置、大小及其与周围结构的毗邻关系。结果椎神经节出现率为83.33%,测得椎神经节长,右侧:男(5.06±2.64)mm,女(4.72±2.56)mm,左侧:男(4.43±2.76)mm,女(4.28±2.43)mm;宽,右侧:男(3.31±1.57)mm,女(2.86±1.96)mm,左侧:男(3.14±0.93)mm,女(3.08±1.56)mm;厚,右侧:男(1.52±1.07)mm,女(1.88±1.56)mm,左侧:男(1.57±0.98)mm,女(2.14±1.21)mm,左右侧椎神经节的长、宽、厚未见统计学差异(P>0.05)。椎神经节的形态多为椭圆形(50%),其主要位于椎动脉起始部稍上方,发出分支与颈胸神经节的节后纤维共同分布于相应部位。两侧椎神经节至颈前正中线的距离及至皮肤的深度相近,无统计学差异(P>0.05)。结论椎神经节为颈部交感神经节的一部分,可能为低位颈中神经节,是颈胸神经节的辅助神经节,与其共同发出节后纤维至靶器官,颈胸神经节阻滞时的不完全阻滞和副反应可能与椎神经节的纤维联系有关。Objective To study the anatomical characteristics of vertebral ganglia,so as to provide the anatomic reference for anesthesia of cervical sympathetic ganglion.Methods Total 30 adult specimens(60 sides)were dissected.The vertebral ganglia and thyroid ganglion were distinguished according to their appearance forms.The morphology,location,size of the vertebral ganglia and the adjacent relationship with surrounding structures were observed.Results The occurrence rate of vertebral ganglia was 83.33%.The length of vertebral ganglia was(5.06±2.64)mm in males and(4.72±2.56)mm in females on the right side,(4.43±2.76)mm in males,(4.28±2.43)mm in females on the left side.The width of vertebral ganglia was(3.31±1.57)mm in males and(2.86±1.96)mm in females on the right side,(3.14±0.93)mm in males and(3.08±1.56)mm in females on the left side.The thickness of vertebral ganglia was(1.52±1.07)mm in males and(1.88±1.56)mm in females on the right side,(1.57±0.98)mm in males and(2.14±1.21)mm in females on the left side.There were no statistical differences in the length,width and thickness of both sides of vertebral ganglia.The vertebral ganglia was mostly oval in shape(50%),which was mainly located slightly above the starting part of vertebral artery.Outgoing branches of vertebral ganglia were distributed in the corresponding parts with the postganglionic fibers of cervicothoracic ganglia.There was no statistical difference in the distance from the vertebral ganglion of both sides to the anterior midline cervical line and the depth from the vertebral ganglion of both sides to the skin(P>0.05).Conclusions The vertebral ganglion is an integral part of cervical sympathetic trunk,which may be the assistant of cervicothoracic ganglion and a part of middle ganglion(lower middle ganglion).Vertebral ganglion sends the postganglionic fiber to the target organ together.The incomplete block and adverse reaction of the cervicothoracic ganglion may be related to the fibrous connection of the vertebral ganglion.

关 键 词：交感神经 麻醉 椎神经节 应用解剖 

分 类 号：R323.2[医药卫生—人体解剖和组织胚胎学]