锁骨下肌的临床解剖学观测

CLINICAL ANATOMY OBSERVATION OF SUBCLAVIUS MUSCLE

目的:为临床治疗锁骨下肌因素引起臂丛神经血管受压征提供解剖学资料。方法:26具常规防腐保存的尸体,重点观察锁骨下肌的形态、神经支配。结果:锁骨下肌缺如7.7％(4/52侧),肌性部长9.3±0.8cm,宽1.1±0.2cm,厚1.0±0.3cm,锁骨下肌的神经成分来源于颈5、6神经根,偶有发自膈神经或颈丛(4％),多见在于水平发出(32.5％)。发出平面为锁骨上2.3±1.0cm,外径约0.9cm。结论:锁骨下肌异常可影响到臂丛神经血管。行锁骨下神经切断术时,应在臂丛上干与肌的内1/3之间区域内寻找,防止损伤内侧的膈神经。

Objective: To apply the clinical anatomy bases for treatment of brachial neurovascular compression syndrome caused by subclavius muscle. Methods: 26 prserved cadavers with 52 sides were studied with emphasis on the morphology of subclavius and nerve to this muscle. Results:The absence of subclavius was found in 7.7% of specimens studied. The subclavius were 9.3 ± 0.8cm in length, 1.1 ± 0.2cm in wide and 1.0 ± 0.3cm in thickness. The subclavius nerve derived from fifth and sixth cervical roots, but seldom from phrenic nerve or cervical plexus. This nerve left the brachial plexus at the level of upper trunk more common-ly(82.5%), with 2.3 ± 1.0cm superior to clavicle. Conclusions: Any anomaly of suclavius may have effects on brachial neurovascular bundle. The suclavius nerve can be found in the zone between upper trunk of brachial plexus and medial one third of the subclavius if apocope is chosen.