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目的探索适合骶后孔骶管阻滞的精确定位方法和适当进针角度与深度,为临床骶管阻滞的治疗提供解剖学依据。方法选取32例尸体标本,剔除骶骨周围的软组织,直至骶骨及骶后孔清楚的显露出来,骶骨正中线为Y轴,髂嵴最高点之间的连线为X1轴,骶角水平线为X2轴,测量各个指标。结果男性骶后孔大小:第1骶后孔>第4骶后孔>第2骶后孔>第3骶后孔;女性骶后孔大小:第1骶后孔>第2骶后孔>第3骶后孔>第4骶后孔,且第2、3、4骶后孔面积差别不大。结论经骶后孔进针骶管阻滞麻醉的理想部位为第2、3骶后孔,最好采用倒“工”型双重坐标法定位,穿刺角度宜向内,角度为30°-40°,进针深度以9.3mm、6.4mm为宜。
Objective To explore the accurate positioning method for caudal sacral sacral obstruction and the appropriate angle and depth of the needle for the purpose of providing an anatomical basis for the clinical treatment of caudal block. Methods Thirty-two cadaveric specimens were selected and the soft tissues around the sacrum were removed until the sacral and sacral holes were clearly exposed. The sacral midline was Y-axis, the connection between the highest point of iliac crest was X1 axis, and the sacral angle horizontal line was X2 axis , Measure each index. Results The size of the posterior sacral foramen in men: the first posterior sacral hole> the fourth posterior sacral sac> the second posterior sacral sac> the third sacral posterior orifice; the size of the posterior sacral sac in the female: the first sacral posterior orifice> the second posterior sacral orifice> 3 posterior sacral hole> 4 posterior sacral hole, and 2,3,4 sacral posterior orifice area difference is not big. Conclusions The ideal site of caudal sac insertion for sacral canal block anesthesia is the second and third posterior foramen. It is best to use the “double” method of positioning the prosthesis, the puncture angle should be inward and the angle is 30 ° - 40 °, the depth of the needle to 9.3mm, 6.4mm is appropriate.