枕大神经卡压综合征的应用解剖学和针刀治疗研究
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作者Author单位AddressE-Mail
韩震 HAN Zhen 广州市第六人民医院,广东广州510655 The 6th People's Hospital of Guangzhou,Guangdong Guangzhou,510655 China  
尹保国 YIN Bao-guo 第一军医大学分校解剖教研室  
刘畅 LIU Chang 第一军医大学解剖教研室  
韩冰 HAN Bing 广州南方医院手术室  
庞伟华 PANG Wei-hua 广州市第六人民医院,广东广州510655 The 6th People's Hospital of Guangzhou,Guangdong Guangzhou,510655 China  
曾展东 ZENG Zhan-dong 广州市第六人民医院,广东广州510655 The 6th People's Hospital of Guangzhou,Guangdong Guangzhou,510655 China  
期刊信息:《中国骨伤》2005年,第18卷,第1期,第10-12页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:为枕大神经卡压综合征临床治疗提供应用解剖学依据和针刀治疗之法。

方法:在20侧成人尸体头颈标本上,对枕大神经的行径、动静脉穿斜方肌腱膜的部位、深筋膜以及易发生卡压的部位进行了解剖观察和测量。对200例具有枕大神经卡压症状的颈椎病患者应用针刀分离松解术,采用不同方向和大小范围分离松解,进行对比性治疗,观察治疗效果有何差异。

结果:枕大神经在枕外隆突下方(28±02)cm,旁开(26±01)cm处穿斜方肌腱膜至皮下;动静脉穿斜方肌腱膜和深筋膜的部位约位于枕外隆突至乳突尖连线的中、上1/3交界点;穿出点有大量腱纤维和筋膜束缠绕枕动静脉,是神经血管发生卡压的部位。

结论:采用枕大神经穿出腱膜和筋膜点的稍内侧进针,从外上向内下方(与后正中线约40°夹角)分离松解,便可解除因神经主干受压引起后半头麻痛。有时往往还需要扩大松解范围,因为枕外隆突至乳突尖连线中1/3外上方枕大神经分支浅出皮下处的分支,易被深筋膜硬化组织粘连和卡压,结合压痛点范围进行扩大松解,才能获得最佳治疗效果。
【关键词】枕大神经  神经卡压综合征  针刺疗法  应用解剖学
 
Study of applied anatomic and acupuncture therapy on the greater occipital nerve compressive syndrome
ABSTRACT  

Objective:To provide the anatomic basis and acupotomologic therapeutic methods for greater occipital nerve compressive syndrome.

Methods:The pathway and position of greater occipital nerve,the position of the arteria and vein through trapezius muscle tendon,deep fascia and predilection site of compression were observed and measured on 20 specimens of adult corpse.200 patients of cevial spondylosis accompanied with greater occipital nerve compression syndrome,which were treated relatively with acupuncture therapy according to different direction and range and observing their clinical effect.

Results::The position of the greater occipital nerve existed descend (2.8±0.2) cm and leave aside (2.6±0.1) cm from external occipital protuberance;the position of the arteria and vein through trapezius tendon and deep fascia existed the point of intersection of median and superior 1/3 of the line from external occipital protuberance to mastoid apex.There were lots of tendon fibers and fascia bond twisted with the greater occipital nerve and the occipital artery and vein at the positions,which was predilection site of compress syndrome.

Conclusion:At the interior site of through aponeurosis and fascia,to loose the greater occipital nerve from exo-superior to inter-inferior by needle,which can treat the greater occipital nerve compression syndrome.The loose area of some patients’ should be enlarged.Because the greater occipital nerve is pressed very easy at this point.We can acquire the best curative effect through enlarging loose area according to painful point.
KEY WORDS  Greater occipital nerve  Nerve compression syndromes  Acupuncture therapy  Applied anatomy
 
引用本文,请按以下格式著录参考文献:
中文格式:韩震,尹保国,刘畅,韩冰,庞伟华,曾展东.枕大神经卡压综合征的应用解剖学和针刀治疗研究[J].中国骨伤,2005,18(1):10~12
英文格式:HAN Zhen,YIN Bao-guo,LIU Chang,HAN Bing,PANG Wei-hua,ZENG Zhan-dong.Study of applied anatomic and acupuncture therapy on the greater occipital nerve compressive syndrome[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(1):10~12
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