利用神经入肌点定位小腿三头肌痉挛的神经阻滞靶点

发布时间：2018-06-22 12:23

本文选题：小腿三头肌 + 肌痉挛　；参考：《中国临床解剖学杂志》2017年01期

【摘要】：目的准确定位小腿三头肌的神经入肌点(N点)位置,为临床该肌痉挛神经阻滞提供解剖学基础。方法 10具20侧成年人尸体下肢,俯卧。紧贴皮肤连接股骨外上髁与内上髁和股骨外上髁与外踝的线分别为N点的横向参考线(H线)和纵向参考线(L线)。解剖暴露小腿三头肌各神经肌支的N点,涂抹硫酸钡,CT扫描。Syngo系统下确定N点在体表的投影点(P点);P点通过N点后投射至对侧皮肤上的P'点;经P点的垂线与H线、水平线与L线的交点分别记为P_H和P_L。分别测量P_H和P_L在H和L线上的百分位置及N点的深度。结果腓肠肌内侧头、外侧头和比目鱼肌的P_H分别位于H线的(46.89±2.73)%、(40.90±3.05)%和(42.56±2.59)%处,P_L分别位于L线的(7.58±2.88)%、(8.15±2.52)%和(17.42±3.31)%处;N点深度分别位于PP'线的(16.32±2.52)%、(13.83±1.77)%和(29.93±2.89)%处。结论这些参数可提高小腿三头肌痉挛神经溶解术的疗效和效率。
[Abstract]:Objective to locate the nerve entry point (N point) of triceps calcaneus accurately and to provide anatomic basis for the clinical use of nerve block in the muscle spasm. Methods the lower limbs of 20 adult cadavers of 10 cadavers were supine. The line between the lateral epicondyle and the medial epicondyle of the femur and the lateral malleolus between the lateral condyle and the lateral malleolus of the femur is the transverse reference line (H line) and the longitudinal reference line (L line) of N point respectively. Dissecting the N points of the nerve branches of the triceps muscle of the calf, applying barium sulfate CT scanning. Syngo system to determine the projection point (P point) of the N point on the body surface and projecting the P 'point through the N point to the contralateral skin, the perpendicular line and the H line through the P point. The intersection of horizontal line and L line is recorded as PSP H and PSP L, respectively. The percent position and the depth of N point on the H and L lines of PSP _ H and P _ S _ L were measured respectively. Results the PSP of medial gastrocnemius head, lateral head and soleus muscle were (46.89 卤2.73) of H line, (40.90 卤3.05)% and (42.56 卤2.59)% of that of L line, (7.58 卤2.88)%, (8.15 卤2.52)% and (17.42 卤3.31)% of PP' line, (13.83 卤1.77)% and (29.93 卤2.89)%, respectively. Conclusion these parameters can improve the curative effect and efficiency of triceps muscle spasm neurolysis.
【作者单位】：遵义医学院人体解剖学教研室;
【基金】：国家自然科学基金(31540031) 贵州省卫计委科学技术基金(gzwjkj2015-1-044) 贵州省科技厅联合基金(黔科合LH字[2015]7528)
【分类号】：R322.8;R651.3

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