摘要： 目的：通过回顾保留副神经的颈淋巴清扫病例中副神经解剖的几种方法，分析总结各种方法的优缺点。方法：本组15例病例中，3例由胸锁乳突肌前缘分离找到副神经大约需25 min；2例由斜方肌前缘分离找到副神经大约需30 min；10例由胸锁乳突肌后缘分离副神经大约需5 min，有的翻瓣完成后即可隐约看见副神经。结果：采用胸锁乳突肌前缘分离找到副神经的3例患者，副神经保留完好，术后肩功能影响较小；采用斜方肌前缘分离找到副神经的2例患者中，有1例分离时副神经被切断，术后肩功能恢复较差；采用胸锁乳突肌后缘分离副神经的10例患者，副神经均保留完好，术后肩功能恢复较好。结论：3种解剖方法中，自胸锁乳突肌后缘分离副神经的方法较简便快捷。

关键词: 颈淋巴清扫术；  , 副神经；  , 肩综合征；  , 颈丛

Abstract: Objective: To compare the pros and cons of different surgical techniques on the exposure of  accessory nerve in neck dissection. Methods: 15 cases with preservation of accessory nerve who underwent neck dissection were retrospectively reviewed. 3 kinds of exposure techniques were employed in this review: group A, through the anterior border of sternocleidomastoid  muscle( 3 cases); group B, through the anterior border of trapezius muscle (2 cases); group C, through the posterior border of sternocleidomastoid muscle ( 10 cases). The advantages and disadvantages between these  methods were summarized. Results: It took 25 minutes of operative length in group A, 30 minutes in group B, and 5 minutes in group C. In some cases, accessory nerves could be recognized immediately after exposure of the flap. In group B, the accessory nerves was cut off in one case, the shoulder function was poorly recovered  after surgery. Conclusion: Exposure of accessory nerve through the posterior border of sternocleidomastoid muscle during neck dissection was relatively simple and quick.

Key words: neck dissection, accessory nerve, shoulder syndrome, cervical plexus

中图分类号: 

• R782

• R739.8