局部麻醉下隆乳术应用解剖

Anatomical study of breast augmentation with the anesthesia of intercostal nerves block

目的:为局部麻醉下隆乳术提供解剖学依据.方法:对26具成年女性的52例标本胸部进行解剖,观测第2～6肋间神经外侧皮支(LCIN)和第2～6肋间神经前皮支(ACIN)的分支分布.结果:第2～6肋间神经外侧皮支穿出点横径依次递减,T2为(2.12±0.26)mm,T6为(0.94±0.25)mm;穿出点至前正中线的距离逐渐增大,T2为(8.87±0.57)cm,T6为(10.17±0.83)cm;穿出点至腋前线距离亦逐渐增大,T2为(1.94±0.91)cm,T6为(1.06±0.18)cm.第2～6肋间神经前皮支(ACIN)在胸骨旁穿出点位置恒定.且肋间神经呈重叠性、节段性分布于乳房区的皮肤.结论:乳房的神经支配主要有锁骨上神经分支和T2～6LCIN的乳房支及T2～6ACIN的乳房支.采用阻滞LCIN和ACIN完全可以满足隆乳术的镇痛要求.

Objective: To provide anatomical basis for breast augmentation with local anesthesia. Methods: T2 -T6 anterior cutaneous branch of intercostal nerve (ACIN) and T2 - T6 lateral cutaneous branch of intercostal nerve (LCIN) were dissected on 52 sides of adult female specimens. Results: Anatomical data about nerves was provided. The diameters of T2 - T6 LCIN of the site perforating were gradually decreasing. The diameter of T2 's was 2.12 ±0.26 mm and the diameter of T6' s was 0.94 ± 0.25 mm. The distances from the site of LCEV perforating to anterior middle line were gradually augmenting. The distance of T2' s was 8.87±0.57 cm and the distance of T6' s was 10.17 ± 0.83 cm. The distances from site of LCIN perforating to axial anterior line were gradually augmenting. The distance of T2 's was 1.94±0.91 cm and the distance of T6's was 1.06±0.18 cm. The position of T2-6 anterior cutaneous branch of intercostals nerve (ACIN) perforating were invariant. Conclusions: The nerve of breasts include superclavicular nerve, the breast branch of ACIN and the breast branch of the lateral cutaneous branch of anterior branch of intercostal nerve (LCIN) . It is possible to block ACIN and LCEV to obtain the ideal anesthesia effect.