摘要
目的探讨手背静脉穿刺时疼痛程度最低的最佳部位,减轻患者的痛苦。方法解剖了12例24侧成人手背标本,观察手背静脉与皮神经的关系,按照手背静脉及皮神经的分布规律,将手背分为1、2、3区,指导临床进行2980例次手背静脉穿刺,用简化McGill疼痛评分表中现有疼痛强度(PPI)进行评分。结果解剖发现桡骨茎突、尺骨茎突及第三掌骨头所形成的三角形区域内神经分布稀疏,神经与静脉呈交叉关系,临床应用证实在此区域内静脉穿刺疼痛分值明显低于其他区域(P<0.01)。结论桡骨茎突、尺骨茎突及第三掌骨头所形成的三角形区域可称为乏神经区,可作为手背静脉穿刺时首选部位,其他区域的静脉穿刺可根据皮神经的体表投影来确定进针点及进针深度,有效地减轻患者痛苦。
Objective To relieve the pain of venepuncture i n the dorsum of the hand.Methods Twelve adult cadaveric hands were carefully dissected to study the relationship between cutaneous nerves and subcutaneous veins in the dorsum of the hand ,and 2980times venepuncture were performed in 3are as of the dorsum manus divided accord ing to the nerve distribution and the pain during the venepuncture was assessed by present pain intensity(PPI )of the short-from McGill pain questi onnaire.Result There were few nerve branches which o nly crossed beneath veins not accompani ed closely with the veins in the trian gular area formed by styloid process of ulan ,styloid process of radius and the third metacarpal bone,the values of PPI were statistically lower in the triangular area than in other o nes(P<0.01).Conclusion The triangular area might be called n erve lacking area and it is the proper location for painless venepuncture in the dorsum of the hand .in the other area ,however ,it is necessary to choose the venepuncture point on t he site of the vein without accompanying nerve and to avoid the point where nerve crossed the vein .
出处
《中国临床康复》
CSCD
2002年第19期2956-2957,共2页
Chinese Journal of Clinical Rehabilitation
