近来,臂丛、颈从、腰丛的神经阻滞法倾向于一针法,其解剖基础是:局麻药注入含有神经和血管的管形鞘内,药液不易外流,能充分浸润鞘内神经组织。这种说法推动了区域麻醉的应用。但是,临床实践并不理想。例如:腋路臂丛神经阻滞应包括尺、桡、正中和肌皮神经,为什么有些神经阻滞出现快而完善,而另一些出现迟缓或不完全,有时有的神经完全无麻醉作用?这说明这些神经可能不在同一鞘内,以致局麻药未能浸润到每一根神经。作者通过尸检、X 线造影拍片、鞘的组织学观察和手术病人染色 CT 检查等多种方法,复查了臂丛鞘的解剖,现将结果报告如下: Recently, the brachial plexus, cervical plexus, and lumbar plexus tend to have a single nerve approach. The anatomic basis is that local anesthetics are injected into the tubular sheath containing nerves and blood vessels, organization. This statement has promoted the application of regional anesthesia. However, clinical practice is not ideal. For example, the axillary brachial plexus block should include the ulnar, radial, median, and musculocutaneous nerves. Why do some nerve blocks appear quickly and completely, while others appear sluggish or incomplete, and sometimes they have no anesthetic effect? Indicating that these nerves may not be in the same sheath, so that local anesthetic fails to infiltrate each nerve. The author reviewed the anatomy of the brachial plexus by autopsy, X-ray angiography, histological observation of the sheath and stained CT examination of surgical patients, etc. The results are reported as follows: