气管旁入法与高位侧入法行星状神经节阻滞的解剖学比较

Comparison of stellate ganglion block with two entry methods in applied anatomy

目的为气管旁入法与高位侧入法行星状神经节阻滞提供解剖学依据。方法选取10具成人头颈胸尸体标本,在舌骨下区和颈外侧区以及胸锁乳突肌区由浅入深解剖至星状神经节处,观察星状神经节及其毗邻结构的关系,用游标卡尺测量相关数据,进行两种入路的比较。结果星状神经节位于第7颈椎基部前方和第1肋骨颈之间,其上缘与颈中神经节中点的距离,男性为(18.10±1.07)mm,女性为(16.71±1.10)mm;从第6颈椎横突前结节的前面观测,星状神经节上下径和左右径分别为(10.25±0.13mm和(14.02±0.58)mm,从侧面观测,其上下径和前后径分别为(9.22±0.14)mm和(2.12±0.52)mm。结论星状神经节阻滞选择气管旁入路法比高位侧入法更为安全且易掌握。

Objective Provide basis for stellate ganglion block （SGB） with trachea side entry and that with inclined entry from high position. Methods Select 10 adult corpse samples with heads, necks and chests （8 male, 2 female）. In lower zone of hyoid bone and side zone of neck as well as sternocleidomastoid muscle （SCN） begin to dissect to stellate ganglion from the shallower to the deeper, observe the relations between the stellate.ganglion and the contiguous structures, measure the relative data by a vernier caliper, compare these two entry. Results Stellate ganglion is between the front of the seventh cervical vertebra root and the neck of the first rib. The distance between the upper part of stellate ganglion and the middle point of neck ganglion （the front of the sixth cervical vertebra tubercle） was （18.10±1.07）mm for male and （16.71±1.10）mm for female. Seeing from it, the up and down diameter was（ 10.25±0.13）mm and the front and back diameter was（ 14.02±0.58）mm. Seeing from the side, the up and down diameter was （9.22±0.14）mm and the front and back diameter was （2.12±0.52）mm. Conclusion SGB choose trachea side entry and the sixth cervical vertebra tubercle as the injection point, which is safer and easier than inclined entry from high position.