【罂粟摘要】超声引导下大舌骨肌与颈内静脉的解剖关系

超声引导下大舌骨肌与颈内静脉的解剖关系

贵州医科大学  麻醉与心脏电生理课题组

翻译：张中伟   编辑：张中伟  审校：曹莹

1   背景和目的  

颈内静脉置管术在临床上应用广泛，对颈内静脉置管术的相关研究较多。然而，紧邻颈内静脉的舌骨肌是舌骨下肌群中很少被提及的肌肉。本研究旨在探讨颈内静脉与舌骨肌在超声引导下的解剖关系，为颈静脉穿刺置管提供理论依据。

2   材料和方法  

这项研究纳入了30名志愿者。志愿者的头部处于中立位置，然后以与床面成30°、45°和60°的角度向左旋转，使用可调量角器进行验证。应用高频超声探头(6~14赫兹)对胸锁乳突肌三角(PASD)顶端平面进行检查，该三角由解剖标志组成：底端为锁骨，两侧头为胸锁乳突肌。胸锁乳突肌三角(PMST)中部平面为一条水平线，连接两侧中点。观察记录右侧舌骨肌(OM)和右侧颈内静脉(IJV)，并进行统计学分析。

3   结果  

PAST组和PMST组在不同头位旋转角度的OM和IJV重叠病例数差异有统计学意义。不同体角的OM值与IJV中点线的夹角及既往左水平位置与PMST的夹角差异有统计学意义。

  4   结论

传统的中路穿刺点为胸锁乳突三角区顶端，在一定程度上可有效避免对舌骨肌的损伤。

原始文献来源：

Yun Yang, Xinqiang Wang, et al.Anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance.[J]. BMC Anesthesiol(2022) 22:181

英文原文：

Anatomical relationship

between the omohyoid muscle and the internal

jugular vein on ultrasound guidance

Abstract

Background: Internal jugular vein catheterization is widely used in clinical practice, and there are many related studies on internal jugular vein catheterization. However, the omohyoid muscle, which is adjacent to the internal jugular vein, is a rarely mentioned muscle of the infrahyoid muscles group. The purpose of this study is to explore the anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance and provide a theoretical reference for jugular puncture and catheterization.

Methods: The study included 30 volunteers. The volunteer’s head lay in the neutral position and was then turned to the left at an angle of 30°, 45° and 60° with the bed surface, as verified using an adjustable protractor. A high- frequency ultrasound probe (6–14 Hz) was used to examine the plane of the apex of sternocleidomastoid triangle (PAST), the triangle consists of anatomical landmarks: a base was clavicle, its sides – heads of sternocleidomastoid muscle. And the plane of the middle of sternocleidomastoid triangle(PMST) which was a horizontal line, connecting midpoints of both sides. The right omohyoid muscle (OM) and the right internal jugular vein (IJV) were observed and recorded for statistical analysis.

Results: There were statistically significant differences in the number of overlapping cases of OM and IJV at each head rotation angle between the PAST and PMST groups. There were statistically significant differences between the angles which OM and IJV centre point line and the left horizontal position of the PAST and PMST at different body angles.

Conclusion: The traditional middle route puncture point is the apex of the sternocleidomastoid triangle, which can effectively avoid injury to the omohyoid muscle, to an extent.

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