迷走神经刺激术前颈动脉鞘内结构超声定位应用价值

VALUE OF PREOPERATIVE ULTRASONIC LOCATION OF CAROTID SHEATH IN VAGUS NERVE STIMULATION

目的研究迷走神经刺激术(VNS)前超声定位颈动脉鞘内迷走神经、颈内静脉(IJV)及颈总动脉(CAA)的应用价值。方法健康成人45例,超声观察左侧颈动脉鞘内的迷走神经、IJV及CCA。结果 45例迷走神经、IJV和CCA均能显示。迷走神经横径(1.13±0.28)mm,前后径(1.01±0.27)mm,平均直径(1.07±0.24)mm。IJV位于CCA前外侧、前侧、外侧和前内侧分别有27、15、1和2例。男性和女性间IJV相对于CCA的位置差异有显著性(χ~2=4.107,P<0.05)。当IJV相对于CCA位置不同时,迷走神经的区域分布差异有显著性(P=0.001)。结论超声检测颈动脉鞘内结构可用于VNS术前的辅助定位。

Objective To investigate the value of ultrasonic location of the vagus nerve,the internal jugular vein（IJV）,and the common carotid artery（CCA）in the carotid sheath before vagus nerve stimulation（VNS）. Methods A total of 45 healthy adults were enrolled,and ultrasound was performed to observe the vagus nerve,the IJV,and the CCA in the left carotid sheath. Results The vagus nerves,IJV,and CCA were clearly shown for all adults.The vagus nerve had a transverse diameter of（1.13±0.28）mm,a longitudinal diameter of（1.01±0.27）mm,and a mean diameter of（1.07±0.24）mm.The IJV was located at the anterolateral,anterior,lateral,and anteromedial side of the CCA in 27,15,1,and 2 adults,respectively.There was a signi-ficant difference in the relative location between the IJV and the CCA between male and female adults（χ~2=4.107,P〈0.05）.There was a significant difference in the distribution of the vagus nerve between the adults with different relative locations between the IJV and the CCA（P=0.001）. Conclusion Preoperative ultrasound location of the carotid sheath is considered a valuable technique for VNS.