迷走神经阻滞入路的相关解剖结构研究

关键词：颈静脉孔  迷走神经  解剖学

Keywords:jugular foramen  vagus nerve  anatomy

摘要：

      目的：对迷走神经阻滞入路相关结构及其毗邻关系进行解剖学观测，为迷走神经阻滞入路和预防并发症的发生提供解剖学基础。方法：对60个成人颅骨（120侧，其中男60侧，女60侧）和30侧成人头、颈部标本迷走神经的毗邻结构进行解剖学观测。结果：迷走神经阻滞进针的深度（乳突尖至颈静脉孔外侧缘的距离）：男性左侧为24.5±0.5mm(17.0—30.2mm)，右侧为24.9±0.7mm(19.5—30.4mm);女性左侧为23.1±0.4mm(16.0—28.5mm)，右侧为22.7±0.6mm(13.0—28.3mm)。观测获得了乳突尖至茎乳孔的距离，茎乳孔至颈静脉窝外侧缘的距离。颈静脉孔的变异情况,迷走神经在颈静脉孔内、外与其他结构的关系。结论：可以乳突为标志作为预测颈静脉孔位置深度的参考数据。穿刺时，应注意避免误伤面神经和颈内静脉。

Abstract:

      Objective：To provide anatomical basis for the approach of blocking vagus nerve and prevention of its complication. Method：Adjacent structures of vagus nerve were measured on 60 adult skulls(120 sides, 60 in each sex)and 30sides of adult specimens. Result：The distances from mastoid to jugular foramen were 24.5±0.5mm(17.0—30.2.mm) and 23.1±0.4mm(16.0—28.5mm) on the left side for males and females respectively; and 24.9±0.7mm(19.5—30.4mm) and 22.7±0.6mm(13.0—28.3mm) on the right side respectively. The distances from the mastoid tip to stylomastoid foramen and from stylomastoid foramen to lateral edge of jugular fossa were measured. The variation of jugular foramen and relationship of vague nerves in and out of jugular foramen and other structures were studied. Conclusion: Stylomastoid foramen can be used as a mark for the prediction of depth location of jugular foramen. Attention should be paid to avoid accidental injury to facial nerves and internal jugular veins in the course of puncture.