摘要
目的探讨皮下组织厚度对低分子肝素注射部位选择的临床意义。方法回顾性分析200例低分子肝素抗凝治疗患者的CT影像资料,测量并对比分析左/右腹部8个区域、左/右上臂部三角肌4个区域、左/右大腿外缘4个区域的皮下组织厚度,每个区域测量上、中、下3个点取平均值。结果左/右腹部各分区上、下部位皮下组织平均厚度差异无统计学意义(P>0.05)。左/右腹部8个区域、左/右上臂部三角肌4个区域、左/右大腿外缘4个区域皮下组织厚度不均衡,左/右前上腹部为(21.65±8.69)mm,左/右前下腹部为(21.68±8.59)mm,左/右中上腹部为(18.32±7.63)mm,左/右中下腹部为(18.04±7.42)mm,皮下脂肪平均厚度明显高于其他区域,差异有统计学意义(P<0.01)。可推荐为低分子肝素轮换注射优选部位。左/右三角肌下缘(17.45±7.28)mm、左/右三角肌外侧缘(17.28±7.06)mm、大腿外侧上缘(17.70±7.38)mm、大腿外侧下缘(17.23±7.17)mm,与左/右中上腹部(18.32±7.63)mm、左/右中下腹部(18.04±7.42)mm比较,差异无统计学意义(P>0.05)。可推荐为低分子肝素轮换注射次选部位。左/右外上腹部(12.13±5.73)mm、左/右外下腹部(13.32±7.82)mm、左/右侧上腹部(12.64±6.25)mm、左/右侧下腹部(13.77±7.42)mm,与其他各区比较,差异有统计学意义(P<0.01)。可推荐除腹部前上/前下、中上/中下区域受限制的低分子肝素轮换注射部位。结论精准测量左/右腹部8个区域、左/右上臂部三角肌4个区域、左/右大腿外缘4个区域的皮下组织厚度,对皮下注射部位的选择可以提供帮助。
Objective To explore the clinical significance of the subcutaneous tissue thickness in determining the injection site of low molecular weight heparin.MethodsThe CT image data of 200patients,who received low molecular weight heparin anticoagulant therapy,were retrospectively analyzed.The subcutaneous tissue thickness was measured at the following areas:8 sites of left/right abdomen,4 sites of left/right deltoid muscle,and 4 sites of the outer edge of left/right thigh.The measurement of subcutaneous tissue thickness was performed at the upper,middle,and lower 3 points of each site,and the mean value was used for analysis.ResultsThere was no significant differences in the mean thickness of subcutaneous tissue between the upper and lower parts of the left/right abdomen(P>0.05).The mean thickness of subcutaneous tissue at left/right anterior upper abdomen was(21.65±8.69)mm,at left/right anterior lower abdomen was(21.68±8.59)mm,at left/right middle upper abdomen was(18.32±7.63)mm,and at left/right middle lower abdomen was(18.04±7.42)mm,which were significantly thicker than those at other areas,the differences were statistically significant(P<0.01).These sites could be recommended as the preferred site for rotational injection of low molecular weight heparin.The mean thickness of subcutaneous tissue at the lower edge of the left/right deltoid muscle was(17.45±7.28)mm,at the lateral edge of the left/right deltoid muscle was(17.28±7.06)mm,at the upper edge of the outer thigh was(17.70±7.38)mm and at the lower edge of the outer thigh was(17.23±7.17)mm,which were not significantly different from the mean subcutaneous tissue thickness of(18.32±7.63)mm at the left/right middle upper abdomen and(18.04±7.42)mm at the left/right middle lower abdomen(P>0.05).These sites could be recommended as the secondary site for rotational injection of low molecular weight heparin.The mean thickness of subcutaneous tissue at the left/right outer upper abdomen was(12.13±5.73)mm,at the left/right outer lower abdomen was(13.32±7.82)mm,at the left/right upper abdomen was(12.64±6.25)mm,and at the left/right lower abdomen was(13.77±7.42)mm,which were significantly different from the mean subcutaneous tissue thickness at other sites(P<0.01).These sites,except for anterior upper/anterior lower and middle upper/middle lower of the abdomen,could be recommended as the rotational injection sites.ConclusionAccurate measurement of subcutaneous tissue thickness at 8 sites of left/right abdomen,4 sites of left/right deltoid muscle,and 4 sites of the outer edge of left/right thigh is helpful in selecting optimal subcutaneous injection site.
作者
李燕
葛静萍
尹媛媛
胡蓝月
孙红霞
LI Yan;GE Jingping;YIN Yuanyuan;HU Lanyue;SUN Hongxia(Department of Vascular and Interventional Radiology,Affiliated Nanjing Hospital of Nanjing Medical University,Nanjing Municipal First Hospital,Nanjing,Jiangsu Province 210006,China)
出处
《介入放射学杂志》
CSCD
北大核心
2023年第1期81-85,共5页
Journal of Interventional Radiology
基金
国家自然科学基金(81871463)
南京市卫生科技发展专项资金项目(YKK19086)
南京市第一医院星火培育计划
关键词
皮下组织厚度
低分子肝素
注射部位
subcutaneous tissue thickness
low molecular weight heparin
injection site
