大鼠星状神经节位置解剖与新型阻滞途径

Anatomical position of stellate ganglion and new way of stellate ganglion block

目的观察大鼠星状神经节(SG)位置解剖,并比较不同方法建立星状神经节阻滞(SGB)模型的成功率。方法 50只Sprague-Dawley(SD)死鼠随机分为2组,分别经后入路方法行左侧(25只)或右侧(25只)SGB,5 min后解剖死鼠,暴露SG并观察其与臂丛、锁骨、胸骨、气管及椎骨等组织器官的位置关系;另取100只雄性正常SD大鼠随机分为2组,分别经皮行前入路左侧(50只)或右侧(50只)SGB,观察Horner征、SG着色情况。结果 50只死鼠经后入路方法行SGB,解剖后7只大鼠SG未着色,其中4只发生椎旁阻滞,1只出现椎管内阻滞,2只注射药物局限在肌肉内,成功率为86.0%(43/50)。100只正常大鼠经前入路行SGB,均未发生致死性并发症,98只大鼠阻滞后1 min内出现阻滞侧Horner征,解剖后3只大鼠SG未着色,其中1只发生椎旁阻滞,2只发生单一臂丛神经阻滞,成功率为97.0%(97/100);前入路行SGB的成功率高于后入路途径(P<0.05)。结论以胸锁关节为体表标志前入路方法行SGB准确性高,且操作简单,并发症少,可作为单次或多次SGB模型。

Objective To observe the anatomical position of stellate ganglion（ SG） in rats and compare the success Sprague-Dawley（ SD） rate in different approaches to establish the model of stellate ganglion block（ SGB） in rats. Methods Fifty dead rats were divided into two groups randomly and received right（ n = 25） or left（ n = 25） SGB through posterior approach respectively. Anatomical position of SG with brachial plexus,clavicle,sternum,trachea and vertebra was observed after five minutes. Another one hundred normal male SD rats were divided into two groups randomly and received right（ n = 50） or left（ n = 50） SGB through anterior approach respectively. The Horner＇s syndrome and the staining results of SG were observed.Results In fifty dead rats,the SG of seven rats were not be stained,among them,paravertebural block occurred in four rats,intrathecal block occurred in one rat and the drug were injected into muscle in two rats. The successful rate of SGB was 86. 0%（ 43 /50）. Fatal complications were not occured in one hundred normal male SD rats who were given right or left SGB through anterior approach. Horner＇s syndrome occurred in ninety-eight rats. The anatomical results showed that SGB was failed in three rats and paravertebural block occurred in one of these rats. Singleness brachial plexus block occurred in two rats. The successful rate of SGB was 97. 0%（ 97 /100）. The sucessful rate of SGB of anterior approach was higher than that of posterior approach（ P〈0. 05）. Conclusion Anterior percutaneous approach,sternoclavicular joint used as body surface symbol to SGB in rats is effective with high veracity,simplicity of operator and few complication,it could be used in establishing once or repeatedly the animal model in the studies of SGB.