星状神经节毗邻关系的解剖学研究

目的：观察星状神经节形状、大小、位置及其与周围组织结构的毗邻关系,为临床进行星状神经节阻滞术提供确切的数据支持。方法：用新鲜成人尸体17具,逐层解剖星状神经节周围结构,暴露星状神经节,测量其大小及与周围结构的距离。结果：星状神经节长为（12．3±3．3）mm,宽为（3．9±1．1）mm,厚为（2．1±0．5）mm,神经节下缘距胸膜顶垂直距离为（55．1±1．5）mm,内侧缘距离颈正中线直线距离为（27．1±5．6）mm,星状神经节和椎动脉在冠状面上的最近距离为（7．6±4．8）mm,星状神经节和椎动脉在矢状面上的最近距离为（1．8±2．0）mm。结论：星状神经节周围组织结构复杂,星状神经节阻滞术易误伤周围结构产生并发症。     

颈下神经节阻滞治疗偏头痛的应用解剖

在４０侧经常规防腐处理的成人尸体标本上观察了颈下神经节（颈胸神经节）的形态、位置，并测量了有关数据。颈下神经节的形态可归纳为星形、椭圆形、亚铃形和圆形４种类型。多居于第７颈椎横突基部与第１肋颈之间的前方，上缘距环状软骨下缘平面为３１．０ｍｍ，内缘距前正中线２９．６ｍｍ，至皮肤的深度为３３．０ｍｍ。依据解剖学观察，拟定了局部定位方法。具体的进针部位和深度，讨论了有关的注意事项，为临床颈下神经节阻滞治     

星状神经节阻滞麻醉的应用解剖

目的:为气管旁入路星状神经节阻滞麻醉提供解剖学依据。方法:对17具(34侧)成人尸体标本进行解剖,对星状神经节的形态、位置及其毗邻结构进行观测。结果:星状神经节出现率为82.35%,其位置位于第7颈椎横突基部和第1肋骨颈之间前方;从颈前皮肤至星状神经节的垂直距离为(31.86±0.72)mm。结论:气管旁入路星状神经节阻滞麻醉选择第6颈椎横突前结节为进针部位是较为安全的方法。     

星状神经节阻滞治疗急性头面部带状疱疹

目的探讨星状神经节阻滞治疗急性头面部带状疱疹的临床治疗效果。方法30例急性头面部带状疱疹患者，冶疗前用视觉模拟评分法（VAS）评估疼痛程度，VAS评分均〉7分，治疗采用1％亚甲蓝1ml，2％利多卡因4ml行患侧星状神经节阻滞，每周1次，两次为1疗程。结果1疗程治疗结束后VAS评分均（3分，其中28例无疼痛。止痛率93．3％．结论星状神经节阻滞治疗惠性头面部带状疱疹疗效确切。     

星状神经节阻滞术的应用解剖

采用星状神经节阻滞术 (ＳＧＢ) [1-3 ] 对多种疾病有治疗效果 ,但因星状神经节 (ＳＧ)周围的解剖复杂 ,穿刺定位较困难。为了临床能更安全便捷地进行星状神经节阻滞术 ,本文对行星状神经节阻滞术中的有关结构作了观测 ,为行星状神经节阻滞术提供了详细的应用解剖学资料。1　材料和方法选用经福尔马林固定后的 30具 (男 2 2 ;女 8)成人尸体标本 ,在颈根部由浅入深逐层解剖观测 ,对行星状神经节阻滞术 (ＳＧＢ)所涉及的结构进行了观测。所得结果经统计学处理。2　结果2 .1　星状神经节的形态和位置　星状神经节有纺缍形(80 % )、哑铃形和三角…     

椎神经节麻醉的应用解剖学研究

目的 观测椎神经节的解剖特征，为临床颈部交感干神经节麻醉提供解剖学依据。方法对30具（60侧）成人大体标本进行解剖，根据出现的形式区分颈中神经节与椎神经节，观测椎神经节的形态、位置、大小及其与周围结构的毗邻关系。结果 椎神经节出现率为83.33%，测得椎神经节长，右侧：男（5.06±2.64）mm，女（4.72±2.56）mm，左侧：男（4.43±2.76）mm，女（4.28±2.43）mm；宽，右侧：男（3.31±1.57）mm，女（2.86±1.96）mm，左侧：男（3.14±0.93）mm，女（3.08±1.56）mm；厚，右侧：男（1.52±1.07）mm，女（1.88±1.56）mm，左侧：男（1.57±0.98）mm，女（2.14±1.21）mm，左右侧椎神经节的长、宽、厚未见统计学差异（P>0.05）。椎神经节的形态多为椭圆形（50%），其主要位于椎动脉起始部稍上方，发出分支与颈胸神经节的节后纤维共同分布于相应部位。两侧椎神经节至颈前正中线的距离及至皮肤的深度相近，无统计学差异（P>0.05）。结论 椎神经节为颈部交感神经节的一部分，可能为低位颈中神经节，是颈...     

星状神经节连续阻滞术治疗颈性眩晕的临床研究

目的 研究星状神经节连续阻滞术对颈性眩晕患者的治疗效果及作用机制分析.方法 通过对43例颈性眩晕采用星状神经节连续阻滞术,观察住院及随访中患者的眩晕等症状改善情况.结果 星状神经节连续阻滞术对颈性眩晕患者有效率达88.4%.结论 连续阻滞术药效持久均匀,避免多次穿刺注药造成痛苦,病人易于接受,值得临床推广应用.     

星状神经节阻滞对急性心肌梗死患者应激激素水平的影响

目的 观察星状神经节阻滞对急性心肌梗死患者体内去甲肾上腺素（NE）、肾上腺素（adrenalin，ADR）、促肾上腺皮质激素（ACTH）、皮质醇（cortisol，ODR）等应激激素水平的影响。方法 选择已被确诊为急性心肌梗死患者68例，随机分为治疗组（34例）和对照组（34例）．治疗组患者采用星状神经节阻滞治疗，两周为一疗程；对照组常规内科治疗。于阻滞前及阻滞后24、48、72、144h抽取静脉血标本。测定各时段的NE、肾上腺素、ACTH、皮质醇应激激素的含量。结果 阻滞后治疗组患者的NE、ADR、ACTH、ODR应激激素的含量与阻滞前及同时段的对照组比较有明显的降低，P〈0．05。结论 星状神经节阻滞可快速有效地缓解由于冠状动脉供血不足引起的缺血性疼痛，抑制应激反应，降低患者体内NE、ADR、ACTH、00R应激激素的水平。     

气管旁入法与高位侧入法行星状神经节阻滞的解剖学比较

目的为气管旁入法与高位侧入法行星状神经节阻滞提供解剖学依据。方法选取10具成人头颈胸尸体标本,在舌骨下区和颈外侧区以及胸锁乳突肌区由浅入深解剖至星状神经节处,观察星状神经节及其毗邻结构的关系,用游标卡尺测量相关数据,进行两种入路的比较。结果星状神经节位于第7颈椎基部前方和第1肋骨颈之间,其上缘与颈中神经节中点的距离,男性为(18.10±1.07)mm,女性为(16.71±1.10)mm;从第6颈椎横突前结节的前面观测,星状神经节上下径和左右径分别为(10.25±0.13mm和(14.02±0.58)mm,从侧面观测,其上下径和前后径分别为(9.22±0.14)mm和(2.12±0.52)mm。结论星状神经节阻滞选择气管旁入路法比高位侧入法更为安全且易掌握。     

Calbindin—D28k mRNA在大鼠三叉神经节和背根节初级传入神…

用原位杂交组织化学技术，用同位素标记的寡核苷酸探针，对Ｃａｌｂｉｎｄｉｎ－Ｄ２８ｋ ｍＲＮＡ在大鼠三叉神经节和背根节初级传入神经元中的表达进行了观察。结果发现：在大鼠三叉神经节中，约１６．１％的神经元为Ｃａｌｂｉｎｄｉｎ Ｄ２８ｋ阳性神经元，而在背根神经节中，阳性神经元占节细胞总数的２０．６％，这两个神经节中的阳性神经元主要集中在大型细胞（８．１％和１２．３％）及小型细胞（４．２％和６．８％）。从     

星状神经节阻滞术及其相关应用解剖研究进展

目的：研究星状神经节阻滞术及其相关应用解剖,从而更好地指导临床工作。方法：查阅国内外相关文献,阐述星状神经节及其毗邻结构的解剖关系,分析星状神经节阻滞术式的发展过程及其并发症。结果：星状神经节毗邻众多重要结构,星状神经节阻滞术有一些比较严重的并发症。结论：术者需熟悉星状神经节周围结构以减少并发症,解剖学研究是一个必需的基础。     

Distribution of preganglionic terminals in the cervical sympathetic ganglia detected by the expression of c-Fos like protein after electric stimulation of the ventral root

To determine the segmental relationship between the upper thoracic spinal cord and cervical sympathetic ganglia, we observed the distribution pattern of postganglionic cells which expressed c-Fos like protein, one of the products of immediate early genes, after electrical stimulation of ventral roots at the T1-T3 spinal segments. We recognized a clear segmental arrangement of postganglionic cells in the stellate ganglion along its rostrocaudal direction corresponding to the segmental arrangement of preganglionic neurons in the spinal cord. That is, postganglionic neurons which expressed c-Fos like protein after stimulation of the T1 ventral root were distributed in the middle region of the stellate ganglion in the rostrocaudal direction. The c-Fos like protein-positive neurons after stimulation of the T2 ventral root were distributed in a more caudal region of the stellate ganglion than after T1 ventral root stimulation. C-Fos like protein-positive neurons after stimulation of the T3 ventral root were mainly situated in a more caudal region of the stellate ganglion than after T2 ventral root stimulation. There was, however, no segmental relationship between the upper thoracic levels of the spinal cord and superior cervical ganglion in the rostrocaudal direction. These results indicate that the segmental innervation of the upper thoracic spinal cord exists in the stellate ganglion, but not in the superior cervical ganglion.     

Stellate ganglion block may relieve hot flashes by interrupting the sympathetic nervous system

Stellate ganglion block is routinely used in pain clinics. The mechanism of action of the stellate ganglion block is uncertain; the most common explanation is that it produces peripheral vasodilation, resulting in neural inhibition in the ganglion's sphere of innervation. However, the wide range of conditions that have been reported to respond favorably to stellate ganglion block suggest that its effectiveness may not be solely the result of increased blood flow nor restricted just to its sphere of innervation. We have found that stellate ganglion block is effective in the treatment of hot flashes in postmenopausal women, as well as those with estrogen depletion resulting from breast cancer treatment. Based on evidence that hot flashes may be centrally mediated and that the stellate ganglion has links with the central nervous system nuclei that modulate body temperature, we hypothesize that the stellate ganglion block provides relief of hot flashes by interrupting the central nervous system connections with the sympathetic nervous system, allowing the body's temperature-regulating mechanisms to reset. If this mechanism can be confirmed, this would provide women with intractable hot flashes with an effective, potentially long-lasting means of relieving their symptoms, and potentially widen the range of indications for stellate ganglion block to include other centrally mediated syndromes.     

Baroreceptor-related dysrhythmias in piglets with selective autonomic denervation of the heart

This study was carried out to determine whether selective cardiac autonomic denervation performed on neonatal swine would evoke dysrhythmias later in development. Piglets (n = 27; 5-10 days old) underwent unilateral stellate ganglion ablation, or right cardiac vagotomy, or sham surgery. Fifty to sixty days after denervation, acute experiments were performed to evaluate responses to baroreceptor activation. Of all animals who exhibited prolonged R-R intervals, only those with right stellate ganglion ablation had prolonged corrected QT intervals. Despite findings suggesting an arrhythmogenic state (predominance of left-sided cardiac innervation), dysrhythmias occurred in all animals with stellate ganglion ablation, regardless of laterality, but in few vagotomized or control animals. Our results suggest that partial sympathetic innervation may alter cardiac function so that dysrhythmias are more likely to occur during baroreceptor activation.     

Microspectrofluorometric quantitation of autofluorescent lipopigment in the human sympathetic ganglia

The age-related changes in lipopigment autofluorescence were studied by microspectrofluorometry in three different types of human neurons: the sympathetic neurons of the stellate and superior mesenteric ganglion and pyramidal neurons of the frontal cortex. The age-related increase in lipopigment autofluorescence was more rapid in stellate ganglion but similar linear increases were found also in superior mesenteric ganglion and frontal cortex. There was an age-related shift in the autofluorescence from yellow to orange in the ganglia. This may be due to the accumulation of neuromelanin in noradrenergic neurons. Lipopigments were identified in sympathetic neurons at the age of 4 months and all neurons carried pigment granules after the age of 64 years. It is concluded that lipopigment autofluorescence is a useful marker for cellular ageing in both the peripheral and the central nervous system.     

Network of the sympathetic nervous system: Focus on the input and output of the cervical sympathetic ganglion

Unlike the thoracic and lumbar sympathetic nervous systems with paravertebral ganglions in individual spinal segments, the cervical sympathetic nervous system lacks segmental structures corresponding to the spinal segments and only three ganglions, namely the upper and middle cervical ganglions and the stellate ganglion, are present. Single axons have been observed in the ganglions using an anterograde-labeling method to analyze their expansion in order to investigate the relationship between the cervical sympathetic ganglions and the spinal cord in rats. Although segmental structures were not confirmed in the upper cervical ganglion, segmental structures were demonstrated in the stellate ganglion. Next, it was determined that some sympathetic preganglionic neurons, nitric oxide synthetase-positive preganglionic neurons, form dense nerve endings on the upper cervical ganglion neurons that project onto organs closely related to glandular secretion in the head and neck region. Finally, the relationship between the cell body size of upper cervical ganglion neurons and the size of the target was investigated for the three major salivary glands in rats and it was determined that no direct relationship was present.     

Novel mechanism of action hypothesized for stellate ganglion block related to melatonin

The mechanism of action of stellate ganglion block has generally been explained by vasodilation within its sphere of innervation. However, the success of treatment cannot always be explained by just one mechanism of action, because its clinical indications in Japan extend to many diseases, including systemic diseases. We propose a new mechanism of action for stellate ganglion block that is based on correction of melatonin rhythm disorder resulting from increased sympathetic nerve tone and does not involve vasodilation.     

Activity of aortic chemoreceptors during electrical stimulation of the stellate ganglion in the cat

1. In anaesthetized cats, action potentials from aortic chemoreceptors were recorded during electrical stimulation of preganglionic sympathetic fibres to the decentralized right stellate ganglion. The rate of discharge in afferents in the ipsilateral but not in the contralateral aortic nerve increased when stimulus frequency was 4/sec or higher.

2. The post-ganglionic fibres in the stimulated pathway originate in the right stellate ganglion. They leave the ganglion in the caudal limb of the ansa subclavia, and the results suggest that the ipsilateral aortic nerve and its branches distribute sympathetic fibres as well as afferents to aortic bodies.

3. In contrast, the rate of discharge of chemoreceptor fibres in the contralateral aortic nerve fell as blood pressure increased during sympathetic stimulation. Sympathetic pathways to the aortic bodies can maintain or increase chemoreceptor discharge during hypertension elicited by sympathetic activation.