Ultrasonographic Findings of the Axillary Part of the Brachial Plexus
Ultrasonographic Findings of the Axillary Part of the Brachial Plexus
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臂丛神经腋部的超声检查结果
DOI：
10.1097/00000539-200105000-00037
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发表时间：
2001
影响因子：
5.7
通讯作者：
W. Mauritz
中科院分区：
文献类型：
--
作者：
G. Retzl;S. Kapral;M. Greher;W. Mauritz
在这项前瞻性研究中，我们试图通过高分辨率超声（US）检查来确定腋窝和上臂主要臂丛神经的解剖变异。对69名健康志愿者（男31名，女38名，中位年龄28岁）上臂三个节段的神经位置进行了超声研究。分析是通过将美国图片细分为八个饼图扇区和匹配的尺神经，桡神经和正中神经的位置的扇区来完成的。在神经通过胸小肌后不久，它们开始分叉。在中层9%-13%，在远端30%-81%的神经与动脉在超声图像中不可见。在通常的腋神经阻滞水平，我们发现59%的志愿者尺神经位于后内侧位置。桡神经位于后外侧（38%）和前外侧（20%），正中神经位于前内侧（30%）和后内侧（26%）。向远端施加轻微的压力可以使神经移位到一侧，特别是当它们位于腋动脉前方时。我们的结论是，腋窝阻滞应尽可能靠近腋窝。
In this prospective study we sought to determine anatomic variations of the main brachial plexus nerves in the axilla and upper arm via high-resolution ultrasonography (US) examination. Positions of nerves were studied via US in three sectional levels of the upper arm in 69 healthy volunteers (31 men and 38 women, median age 28 yr). Analysis was done by subdividing the US picture into eight pie-chart sectors and matching sectors for the position of the ulnar, radial, and median nerves. Shortly after the nerves pass the pectoralis minor muscle, they begin to diverge. At the middle level 9%–13%, and at the distal level, 30%–81% of the nerves are not seen together with the artery in the US picture. At the usual level of axillary block approach, we found the ulnar nerve in the posterior medial position in 59% of the volunteers. The other two nerves had two peaks in distribution: the radial nerve in posterior lateral (38%) and anterior lateral (20%) position, and the median nerve in anterior medial (30%) and posterior medial (26%) position. Applying light pressure distally can displace nerves to the side, especially when they are positioned anterior to the axillary artery. We conclude that an axillary block should be attempted as proximal as possible to the axilla.