上胸交感神经的外科解剖(英文 )

SHI  Xianzhong1; LUAN  Liju1; LIU Yanguo2; CHEN  Chunhua1; JIN  Duo1; LIU  Shengyong1; ZHOU  Changman1; ZHANG  Weiguang1*

doi:10.16098/j.issn.0529-1356.2026.01.015

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解剖学报 ›› 2026, Vol. 57 ›› Issue (1) : 100-104. DOI: 10.16098/j.issn.0529-1356.2026.01.015

解剖学

上胸交感神经的外科解剖(英文 )

石献忠¹栾丽菊¹刘彦国²陈春花¹金铎¹刘胜勇¹周长满¹张卫光^1*

作者信息 +

Surgical anatomy of upper thoracic sympathetic nerve

SHI Xian-zhong¹, LUAN Li-ju¹, LIU Yan-guo², CHEN Chun-hua¹, JIN Duo¹, LIU Sheng-yong¹, ZHOU Chang-man¹, ZHANG Wei-guang^1*

Author information +

文章历史 +

摘要

目的准确描绘上胸椎交感神经干及其分支的显微解剖，为临床精准手术入路的选择提供解剖学依据。方法本研究观察测量了28具中国成年尸体（男性18具，女性10具）的55条交感干。彻底显露胸腔，用显微仪器观察并测量交感神经节及其附属分支。结果所有标本均由第1胸神经（T1）的肋间神经分支进入第2肋上缘上方的星状神经节，分支与第2肋上缘的距离为（5.1±1.4） mm。T2~T5神经节位于相应肋间隙的发生率分别为92.7%、85.5%、40.0%和36.4%。根据胸交感神经节与肋间神经的解剖关系，将其分为a型、b型和c型。3种交通支距相对肋中点外侧交感干的距离分别为（10.2±3.4） mm （a型）、（9.5±2.6） mm （b型）和（8.4±2.0） mm （c型）。74.5%的肋间上动脉穿过第1肋颈。肋间上动脉与外侧交感干的距离为（3.4±1.3） mm。结论在肋骨水平行交感神经切除术是临床上治疗掌部或颅面多汗症的理想选择，去神经范围较小，治疗效果更明确。

Abstract

Objective To clearly delineate the microanatomy of the upper thoracic sympathetic trunk and its syntopy in order to provide anatomical basis for the selection of precise clinical surgical approaches. Methods Totally 55 sympathetic trunks available in 28 Chinese adult cadavers (18 males and 10 females) were investigated in this study. The thoracic cavity was thoroughly exposed and then sympathetic ganglia and its affiliated rami were observed and measured with microscopic instruments. Results Rami from thoracic nerve 1 (T1) intercostal nerve entered the stellate ganglion above the upper border of the second rib in all specimens. The distance between the rami and the upper border of the second rib was (5.1 ± 1.4) mm. The incidence that T2-T5 ganglions located at the corresponding intercostal space was 92.7%, 85.5%, 40.0% and 36.4%, respectively. The rami communicantes were classified into 3 types (type a, b and c) according to the anatomical relationship between the thoracic sympathetic ganglia and the intercostal nerves. The distance from 3 types of rami communicantes to lateral sympathetic trunk at the middle point of relative rib was (10.2 ± 3.4) mm (type a), (9.5 ± 2.6) mm (type b) and (8.4 ± 2.0) mm (type c), respectively. We found that 74.5% superior intercostal artery crossed the neck of the first rib. The distance between the superior intercostal artery and the lateral sympathetic trunk was (3.4 ± 1.3) mm. Conclusion Sympathectomy performed at rib level should be the ideal choice for clinical surgical treatment of palmar or craniofacial hyperhidrosis with less denervation scope to achieve more definite therapeutic effect.

导出引用

石献忠栾丽菊刘彦国陈春花金铎刘胜勇周长满张卫光. 上胸交感神经的外科解剖(英文 )[J]. 解剖学报. 2026, 57(1): 100-104 https://doi.org/10.16098/j.issn.0529-1356.2026.01.015

SHI Xian-zhong, LUAN Li-ju, LIU Yan-guo, CHEN Chun-hua, JIN Duo, LIU Sheng-yong, ZHOU Chang-man, ZHANG Wei-guang. Surgical anatomy of upper thoracic sympathetic nerve[J]. Acta Anatomica Sinica. 2026, 57(1): 100-104 https://doi.org/10.16098/j.issn.0529-1356.2026.01.015

中图分类号： R338.21

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