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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。
Objective To accurately locate the position of nerve entrance point (N point) of the triceps muscle of the calf and provide an anatomical basis for clinical nerve block of the muscle spasm. Method 10 with 20 adult cadaveric lower extremities, prone. Close to the skin connecting the femoral epicondyle and the medial epicondyle and the femoral epicondyle and lateral malleolus were N points horizontal reference line (H line) and longitudinal reference line (L line). Anatomically expose the N points of each muscle branch of the calf triceps, smear barium sulphate, and CT scan. Syngo system to determine the N point in the body surface projection point (P point); P points through the N points after projection to the contralateral skin P ’point; by the P point of the vertical and H lines, horizontal and L line of intersection Respectively denoted as P_H and P_L. The percentages of P_H and P_L on the H and L lines, respectively, and the depth of point N were measured. Results The P_H of medial head, lateral head and soleus of gastrocnemius muscle were (46.89 ± 2.73)%, (40.90 ± 3.05)% and (42.56 ± 2.59)% respectively at H line and (7.58 ± 2.88) (16.32 ± 2.52)%, (13.83 ± 1.77)% and (29.93 ± 2.89)% of the PP ’line, respectively. The depth of N point was (8.15 ± 2.52)% and (17.42 ± 3.31)% respectively. Conclusion These parameters can improve the efficacy and efficiency of neurolysis of the triceps spasm in the lower leg.