摘要
目的 探讨经臀骶髂关节 (sacroiliacjoint,SIJ)穿刺的最佳途径和穿刺的安全性。方法 防腐盆部标本SIJCT扫描 ,于低温冷冻下参照CT扫描基线行水平断层或冠状断层。观察SIJ在不同层面的表现 ,并与CT图像对照分析。结果 断层标本显示SIJ包括滑膜部和韧带部 ,CT显示的骶髂骨间隙不全是滑膜部。SIJ下 1/ 3 ,则全为滑膜部所占据 ,且其后面无骨质覆盖 ,但其下半部为SIJ边缘且骨盆壁较薄。从臀部至SIJ后缘路径无重要神经、血管 ,虽然SIJ盆面有腰骶干及髂血管等经过 ,但远离穿刺部位 ,不失为最佳穿刺途径。结论 经臀SIJ最佳穿刺部位为SIJ下 1/ 3的上半部。经该途径穿刺安全 ,但不宜过深 ,以免穿透盆壁 ,误伤盆内结构。
Objective To investigate the best pathway and safety of sacroiliac joint (SIJ) puncture.Methods The anticorrosive adult specimens were frozen after SIJ CT scan.Horizontal or coronary sectioning was done.The horizontal sectioning was done corresponding to CT scan.The structures of different sections were observed and compared with the corresponding CT scans.Results According to the horizontal sectioning,the SIJ included synovial portion and ligamentous portion.As shown by CT,only part of the space between sacrum and ilium was the synovial portion,which occupied the whole part of the lower 1/3 segment SIJ,and the posterior was not covered with bones.There are no important nerves and blood vessels passing through the route from the buttock to the posterior of SIJ.Thus,the pathway can be regarded as the best and safe one although the lumbosacral trunk and iliac blood vessels go through the anterior of SIJ in the pelvis.Conclusion The best pathway of SIJ puncture is the upper part of the lower 1/3 segment.The safety of puncture depends on not penetrating the pelvic cavity to avoid damaging the structures in pelvis.
出处
《中华风湿病学杂志》
CAS
CSCD
2001年第4期237-239,T002-T003,共5页
Chinese Journal of Rheumatology
