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目的研究颈交感干(CST)和颈长肌(LC)的解剖学特征及其临床意义。方法取32例成人尸体标本,剥离颈部肌肉及软组织,保留CST和LC,测量CST神经节的尺寸、神经节之间的距离、两侧LC内侧缘及CST与颈胸段脊椎前方中线的距离、两侧LC内侧缘之间的夹角。结果 CST中上神经节(SG)和下神经节(IG)或颈胸神经节(CTG)恒定存在,分别位于C_2~C_3、C_7~T_1水平;中神经节(MG)在28.1%的标本中观察到,位于C_6水平,且其中2例标本单侧MG为双节;IG在25.0%的标本中观察到。标本左右侧SG、MG、IG、CTG、椎神经节的长度、宽度和厚度均无统计学差异(P>0.05)。两侧LC内侧缘间距离由上往下逐渐增宽,而两侧CST间距则逐渐减少。左侧CST与椎体中线的夹角为(11.2±1.8)度,右侧为(10.3±1.4)度,左右两侧无统计学差异(P>0.05)。结论 CST和LC的走行有其解剖学特点。当LC被过度牵拉或横行切断时,CST最易被损伤,尤其位于C_6~C_7水平。熟悉CST和LC的局部解剖有利于术中辨别和避免交感干损伤。
Objective To study the anatomic features of cervical sympathetic trunk (CST) and cervical longissimus dorsi (LC) and its clinical significance. Methods Twenty-two adult cadaveric specimens were dissected, the neck muscle and soft tissue were dissected, CST and LC were preserved, the size of CST ganglion, the distance between ganglion, the medial margin of LC and the distance between CST and anterior cervical spine of neck , Both sides of the LC between the lateral edge of the angle. Results The upper ganglion (SG) and the lower ganglion (IG) or the neck thoracic ganglion (CTG) were found in CST, which were located at the level of C_2 ~ C_3 and C_7 ~ T_1, respectively. The level of middle ganglion (MG) in 28.1% It was observed that at C_6 level, and two of the two specimens were single-sided MG with two nodes; IG was observed in 25.0% of the specimens. There was no significant difference in the length, width and thickness of SG, MG, IG, CTG and vertebral ganglion between the left and right sides of the specimens (P> 0.05). The distance between the inner edge of the LC on both sides gradually widened from top to bottom, while the CST spacing on both sides gradually decreased. The angle between the left CST and the midline of the vertebral body was (11.2 ± 1.8) degrees and the right was (10.3 ± 1.4) degrees, with no significant difference between the left and right sides (P> 0.05). Conclusion The movement of CST and LC has its anatomical characteristics. When the LC is too much stretch or transverse cutting, CST most likely to be damaged, especially in the C_6 ~ C_7 level. Familiar with the local anatomy of CST and LC is conducive to intraoperative identification and avoid sympathetic injury.