本文選題：前鋸肌間隙　切入點：美蘭　出處：《中國臨床解剖學雜志》2017年05期 　論文類型：期刊論文

【摘要】：目的觀察測量前鋸肌間隙美蘭溶液擴散范圍及神經(jīng)分布,為該間隙神經(jīng)阻滯提供解剖學依據(jù)。方法選用4具尸體,應用超聲引導技術,采用Blanco穿刺入路,在胸壁兩側腋中線4、5肋間,注入含美蘭染料的液體(0.4 ml/kg)至前鋸肌間隙,約10 min后逐層分離至該間隙,觀察美蘭液體的擴散范圍、染料沉積后界限以及該范圍內(nèi)的神經(jīng)分布。結果觀察8側前鋸肌,逐層掀開胸大肌和胸小肌后,清晰顯露前鋸肌間隙的藍染區(qū)域及區(qū)域內(nèi)藍染的2~6肋間神經(jīng)的外側皮支、胸長神經(jīng)和胸背神經(jīng)。中位數(shù)M(P25,P75)描述8個前鋸肌筋膜間隙注射擴散范圍測量結果,腋前線11.35(10.45,12.15)cm,腋中線12.6(12.12,13.15)cm,腋后線11.1(10.70,12.05)cm,平乳頭線9.8(9.12,10.65)cm。頭側擴散至第2肋腋前線占75%,腋中線占87.5%,腋后線占87.5%;擴散至第3肋腋前線占25%,腋中線占12.5%,腋后線占12.5%。結論前鋸肌間隙美蘭溶液擴散范圍解剖測量研究提示臨床應用此方法進行前鋸肌間隙神經(jīng)阻滯,可阻滯前鋸肌間隙內(nèi)的2~6肋間神經(jīng)外側皮支、胸長神經(jīng)和胸背神經(jīng),滿足胸前外側壁手術的麻醉和鎮(zhèn)痛。
[Abstract]:Objective to observe and measure the diffusion range and nerve distribution of methylene blue solution in anterior serratus space so as to provide anatomic basis for nerve block in the space. Methods four cadavers were selected and Blanco puncture approach was used to guide 4 cadavers. In the intercostal space of the axillary midline on both sides of the chest wall, a liquid containing methylene dye (0.4 ml / kg) was injected into the space of the anterior serratus. After about 10 min, the space was separated layer by layer, and the diffusion range of the liquid was observed. Results after 8 sides of serratus anterior muscle and pectoralis minor muscle were opened layer by layer, the blue-stained area and the lateral cutaneous branch of the 26 intercostal nerves in the space of serratus anterior muscle were clearly revealed. Median Mannus P25 P75) describes the results of diffusive range measurements of 8 anterior serratus interfascial injection, the median of which is the median of the thoracic nerve and the dorsal thoracic nerve. The axillary front 11.35 ~ 10.45 ~ 12.15 cm, the axillary midline 12.6 ~ 12.12 ~ 13.15 cm, the posterior axillary line 11.1 ~ 10.70 ~ 12.05 cm, the flat nipple line 9.8 ~ 9.12 ~ 10.65 cm, the head spreading to the front of the second costal axillary line 75 ~ 75 cm, the midaxillary line 87.5, the posterior axillary line 87.5; the diffusive line to the third rib axillary front 25; the middle axillary line 12.5m; the posterior axillary line 12.5. conclusion the anterior serratus muscle interspace is 12.5. The anatomic measurement of solution diffusion range suggested that this method could be used to block the anterior serratus space nerve. It can block the lateral cutaneous branch of intercostal nerve, long thoracic nerve and thoracic dorsal nerve in the space of anterior serratus muscle, which can be used for anaesthesia and analgesia of anterolateral thoracic wall operation.
【作者單位】： 長治醫(yī)學院麻醉學系;
【基金】：山西省高等學校大學生創(chuàng)新創(chuàng)業(yè)項目(2015308) 山西省高等學校特色專業(yè)建設項目(201509) 山西省高等學校教學改革項目(2011073)
【分類號】：R322

【相似文獻】

相關期刊論文 前9條

1 韓震,鐘世鎮(zhèn),孫博,劉牧之,何蘊韶,彭義森,孟石合,顧玉東;前鋸肌及其神經(jīng)支配的解剖學研究[J];臨床解剖學雜志;1986年03期

2 李壽田;薛黔;;前鋸肌的肌構筑學研究[J];遵義醫(yī)學院學報;2008年04期

3 李慧有;桂國成;馬裕兵;常加志;;前鋸肌筋膜瓣的應用解剖學研究[J];臨床應用解剖學雜志;1985年04期

4 杜建平,徐達傳,于涯濤,鐘世鎮(zhèn);前鋸肌下部肌皮瓣移植的應用解剖[J];中國臨床解剖學雜志;1998年04期

5 何國棟,姜蘇明;帶神經(jīng)蒂前鋸肌轉位心肌成形術的應用解剖[J];廣東解剖學通報;1994年01期

6 紀榮明,劉芳,黃會龍,李玉泉,李軍輝;前鋸肌瓣乳房再造或豐乳術的應用解剖[J];中國臨床解剖學雜志;2003年04期

7 徐前鋒，馮承臣，劉瑞軍;帶血管神經(jīng)蒂的下前鋸肌皮瓣移植17例[J];中華顯微外科雜志;1996年03期

8 鄔江，鐘世鎮(zhèn)，徐達傳，李主一;前鋸肌和背闊肌聯(lián)合肌瓣修復晚期面癱的應用解剖[J];中國臨床解剖學雜志;1996年03期

9 李桂蘭;前鋸肌肌骨瓣的應用解剖[J];中國臨床解剖學雜志;1989年03期

相關會議論文 前1條

1 彭耀金;李有秋;;前鋸肌標本的設計與制作[A];解剖學雜志——中國解剖學會2002年年會文摘匯編[C];2002年

相關碩士學位論文 前1條

1 朱邦中;帶下部前鋸肌的側胸皮瓣解剖研究和臨床應用[D];安徽醫(yī)科大學;2011年

，

本文編號：1632608