改良的臂丛阻滞麻醉

目的 探讨解剖学对臂丛神经阻滞麻醉的影响，为临床研究及应用提供参考依据。方法 选取20具尸体，应用经改良的喙突下臂丛神经阻滞法入路定位，进行垂直穿刺，神经阻滞点采用蓝色染料标记，同时对神经集中部位与标记点进行解剖暴露，探查神经集中点和体表标志之间的解剖关系。结果 左侧集中部位上缘到锁骨下缘中点、胸锁关节下缘、肩峰及喙突下缘的距离分别为（3.62±0.24）cm、（10.39±0.25）cm、（6.67±0.18）cm及（2.80±0.19）cm；右侧集中部位上缘到锁骨下缘中点、胸锁关节下缘、肩峰及喙突下缘的距离分别为（4.24±0.27）cm、（11.10±0.28）cm、（6.35±0.19）cm及（3.03±0.15）cm。 结论 局部解剖学的应用提高臂丛神经阻滞的准确性，从而可提高臂丛神经阻滞麻醉的效果，为临床研究及应用提供参考依据。

Modified braclial plexus block anesthesia

Objective To analyze the influence of topographic anatomy on brachial plexus block anesthesia,and to provide reference for clinical research and application. Methods Total of 20 cadavers were selected and located through the modified method of inferior brachial plexus block of the coracoid process. The nerve blocking points were marked with blue dye,and the nerve concentration sites and marking points were dissected and exposed at the same time. The anatomical relationship between nerve concentration points and body surface markers were explored. Results The distances from the upper margin of the left centralization to the midpoint of the subclavian border,the inferior margin of the sternoclavicular joint,the shoulder peak and the inferior edge of the coracoid process were( 3. 62± 0. 24) cm,( 10. 39 ±0. 25) cm,( 6. 67 ± 0. 18) cm and( 2. 80 ± 0. 19) cm,respectively. The distances from the upper edge of the right centralization to the midpoint of the subclavian border,the inferior margin of the sternoclavicular joint,the shoulder peak and the inferior edge of the coracoid process were( 4. 24±0. 27) cm,( 11. 10±0. 28) cm,( 6. 35±0. 19) cm and( 3. 03±0. 15) cm,respectively. Conclusion The application of anatomy improves the accuracy of brachial plexus block,thus improves the effect of brachial plexus block anesthesia,and provides a powerful reference for clinical research and application.