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目的准确定位大圆肌神经入肌点(NEP)的体表位置和穿刺深度。方法 12具中国成年人尸体。设计紧贴皮肤连接颈静脉切迹最低点至肩峰尖为横向参考线(H线)、颈静脉切迹最低点至剑胸结合处为纵向参考线(L线)。解剖暴露大圆肌NEP,涂抹硫酸钡,逐层复位缝合,CT扫描与三维重建。Syngo系统下确定大圆肌NEP的体表投影点(P);P通过NEP投影至背部皮肤上的点为P’点;经P的垂线与H线的交点记为PH,经P的水平线与L线的交点记为PL;分别测量PH和PL在H和L线上的百分位置及NEP的百分深度。结果大圆肌NEP的PH位于H线的(9.59±1.24)%处,PL位于L线的(39.37±2.45)%处;NEP深度位于PP’线的(41.83±2.98)%处。结论这些参数可为提高大圆肌痉挛的神经阻滞效率和疗效提供指导。
Objective To accurately locate the surface position and puncture depth of the epiphysisus locus (NEP). Method 12 with Chinese adult body. Design close to the skin connection jugular notch the lowest point to acromiocutaneous horizontal reference line (H line), the lowest point of jugular vein notch to the junction of the sword and chest vertical reference line (L line). Dissect the large circular muscle NEP, smear barium sulphate, layer by layer suture, CT scan and 3D reconstruction. Syngo system to determine the surface of the circular dorsi NEP projection point (P); P through the NEP projection to the skin on the back of the point P ’point; P by the vertical line and H line of the intersection marked as PH, The intersection points of L line are recorded as PL; the percentages of PH and PL on H and L lines and the percent depth of NEP are respectively measured. Results The PH value of NEP in the great great circular muscle was (9.59 ± 1.24)% at line H, PL was at 39.37 ± 2.45% at line L, and the depth of NEP was at (41.83 ± 2.98)% of PP ’line. Conclusion These parameters may provide guidance for improving the efficiency and curative effect of nerve block in the great spina bifida.