目的:本系统综述的目的是研究膈神经的膈下解剖结构。
方法:对WebofScience数据库进行了计算机化的系统搜索。使用的关键术语是膈神经,子隔膜*,esophag*,肝脏,胃,pancre*,十二指肠*,intestin*,肠,gangli*,biliar*,奥迪,胆囊,Peritone*,脾,脾脾,hepat*,格里森,镰状,冠状韧带,肾,肾上,和肾上腺。还审查了“引用的”文章,以确保包括所有适当的研究。
结果:共发现一千三百三十篇文章,其中18项符合纳入和排除标准。尸体研究质量评估量表显示,人体研究的方法学质量相当高,而实验室动物实验风险工具系统审查中心的修改版本表明动物研究的方法学质量较差。根据人类研究,已经证明了胃食管交界处的膈供应,胃,腹腔神经节,肝脏和它的冠状韧带,下腔静脉,胆囊和肾上腺,一半的人体样本显示膈神经与任何膈下结构的连接。
结论:这篇综述提供了膈下神经供应和连接的第一个系统证据。这对于照顾患有颈部和肩部疼痛的人的专业人士来说是感兴趣的,以及周围膈肌疾病或打嗝的患者。然而,关于这种供应的自主神经或感官性质存在争议。
OBJECTIVE: The aim of this systematic review is to study the subdiaphragmatic anatomy of the phrenic nerve.
METHODS: A computerised systematic search of the Web of Science database was conducted. The key terms used were phrenic nerve, subdiaphragmat*, esophag*, liver, stomach, pancre*, duoden*, intestin*, bowel, gangli*, biliar*, Oddi, gallbladder, peritone*, spleen, splenic, hepat*, Glisson, falciform, coronary ligament, kidney, suprarenal, and adrenal. The \'cited-by\' articles were also reviewed to ensure that all appropriate studies were included.
RESULTS: A total of one thousand three hundred and thirty articles were found, of which eighteen met the inclusion and exclusion criteria. The Quality Appraisal for Cadaveric Studies scale revealed substantial to excellent methodological quality of human studies, while a modified version of the Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias Tool denoted poor methodological quality of animal studies. According to human studies, phrenic supply has been demonstrated for the gastro-esophageal junction, stomach, celiac ganglia, liver and its coronary ligament, inferior vena cava, gallbladder and adrenal glands, with half of the human samples studied presenting phrenic nerve connections with any subdiaphragmatic structure.
CONCLUSIONS: This review provides the first systematic evidence of subdiaphragmatic phrenic nerve supply and connections. This is of interest to professionals who care for people suffering from neck and shoulder pain, as well as patients with peridiaphragmatic disorders or hiccups. However, there are controversies about the autonomic or sensory nature of this supply.