摘要
目的探寻可供临床和教学参考的八髎穴骨度折量定位方法。方法对南京医科大学附属南京医院2016年1月至6月的100例俯卧位盆腔CT片进行回顾性分析,以5mm层厚连续横断面扫描,建立3D图像。测量L5棘突下至尾骨尖、L5棘突下至骶管裂孔、L5棘突下至髂后上棘、L5棘突下至八髎穴、后正中线至八髎穴、后正中线至髂后上棘等距离。结果 (1)设立骶部骨度表,得到4个骶部折量寸:即L5棘突下至尾骨尖约6寸,L5棘突下至骶管裂孔约3寸,L5棘突下至髂后上棘的垂直距离约1寸,髂后上棘至后正中线约2寸。(2)根据骶部骨度分寸,八髎穴可定位如下:上髎位于后正中线旁开1.1寸,L5棘突下1寸;次髎位于后正中线旁开1寸,L5棘突下1.7寸;中髎位于后正中线旁开0.9寸,L5棘突下2.5寸;下髎位于后正中线旁开0.9寸,L5棘突下3.5寸。(3)根据骶部体表标志,八髎穴可定位如下:从骶部纵向距离观察,上髎穴约平髂后上棘,次髎穴约平L5棘突下和骶管裂孔连线的中点,中髎穴约平L5棘突下和尾骨尖连线的中点,下髎穴约平骶管裂孔;从骶部横向距离观察,次髎穴位于髂后上棘至后正中线距离的一半,八髎穴呈"倒八字"型排列,其连线与后正中线的夹角约25°。结论以表面标志为基础,用比例关系和骨度分寸来定位八髎穴,具有临床参考价值。
OBJECTIVE To explore Baliao points location method by proportional bone measurement and provide reference for clinic and teaching.METHODS 100 prone pelvic CT images performed from January 2016 to June in Nanjing Hospital Affiliated to Nanjing Medical University was analyzed retrospectively.Three D images were established by continuous cross section scanning with 5mm layer thickness.The distances of L5 spinous process to coccyx tip,L5 spinous process to sacral hiatus,L5 spinous process to the posterior superior iliac spine,L5 spinous process to Baliao points,posterior midline to Baliao points and posterior midline to the posterior superior iliac spine were measured.RESULTS ①Four sacral bone measurements were obtained through establishing sacral bone scale,they were about 6 cun from L5 spinous process to coccyx tip,3 cun from L5 spinous process to sacral hiatus,about 1 cun from L5 spinous process to the posterior superior iliac spine vertically,about 2 cun from posterior superior iliac spine to posterior midline.②Baliao points could be located as follows on the basis of sacral bone scale:Shangliao(BL 31)was located in 1.1 cun next to posterior midline,1 cun below L5 spinous process;Ciliao(BL 32)was located in 1 cun next to posterior midline,1.7 cun below L5 spinous process;Zhongliao(BL 33)was located in 0.9 cun next to posterior midline,2.5 cun below L5 spinous process;Xialiao(BL 34)was located in 0.9 cun next to posterior midline,3.5 cun below L5 spinous process.③Baliao points could be located as follows according to body surface signs of partes sacralis:from the longitudinal distance of partes sacralis,Shangliao(BL 31)was parallel with the posterior superior iliac spine;Ciliao(BL 32)was parallel with the midpoint of L5 spinous process and sacral hiatus;Zhongliao(BL 33)was parallel with the midpoint of L5 spinous process and coccygeal tip;Xialiao(BL 34)was parallel with the sacral hiatu.From the transverse distance of partes sacralis,Ciliao(BL 32)was located in the midpoint of the posterior superior iliac spine and posterior midline.Baliao points were lined as reversal"八",and the angle between the connection of Baliao points and the posterior midline was 25 degrees.But the body surface signs and bone standard could only provide the most likely location for Baliao,so Baliao points location could be confirmed through combining point identification and touching the hollow.CONCLUSIONS On the basis of body surface signs,transforming"measurement"to"standard",and locating Baliao points according to proportional relationship and bone degree,which are worthy of clinical reference.
作者
金洵
丁曙晴
时飞跃
王玲玲
任军
吴正参
JIN Xun;DING Shu-qing;SHI Fei-yue;WANG Ling-ling;REN Jun;WU Zheng-can(The Second Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing,210023,China;The Third Affiliated Hospital of Nanjing Medical University,Nanjing,210001,China;Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing,210006,China)
出处
《南京中医药大学学报》
CAS
CSCD
北大核心
2018年第2期143-146,156,共5页
Journal of Nanjing University of Traditional Chinese Medicine
基金
江苏省高校自然科学研究面上项目(15KJB360004)
江苏省自然科学基金(BK20161049)
国家自然科学基金(81603674)
关键词
八髎
折量
骨度分寸
表面标志
Baliao points
Bone Standard of Sacral Region
bone degree
body surface signs
