应用CT三维重建技术对290例骶后孔(八髎穴)变异性的研究
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摘要
目的:通过总结分析骶后孔(八髎穴)的变异率和变异类型,引起临床医师对骶后孔(八髎穴)变异性的重视,为研究取穴方法提供理论基础。方法:对290例行盆腔CT检查患者资料进行三维重建,对骶后孔(八髎穴)的变异情况进行判别、归类、分析。结果:骶后孔(八髎穴)的总变异率为20.34%(59/290),变异类型包括椎体个数变异型(4椎变异、6椎变异)、融合变异型(腰骶融合、骶尾融合、腰骶融合+骶尾融合、腰骶融合+骶椎4变异)和混合型。结论:椎体个数变异型会导致骶神经数量变化,融合变异型和混合型会加大取穴难度,而髂后上棘一般不会发生变异,用于八髎穴取穴定位更佳。髂后上棘连线多位于上髎水平线上;髂骶距中点多位于中髎水平线上。
Objective To observe the variation of sacral vertebrates and foramen involving the bilateral Shangliao(BL 31),Ciliao(BL 32),Zhongliao(BL 33)and Xialiao(BL 34,Baliao acupoints),so as to provide an anatomic basis of acupoint needling in clinical practice.Methods A total of 290patients[161men and 129 women,mean age and standard deviation,(63.6±13.3)years old and(59.5±13.3)years old,respectively]with intact pelvic structure were recruited in the present study.Computed tomography(CT)scans of intact pelves were taken using a SOMATOM Definition AS 128 and the acquired signals were imported into Siemens Syngo Inspace platform for 3Dreconstruction,followed by identification,classification and analysis of the variation of sacral foramen(Baliao acupoint).Results The total variation rate of posterior sacral foramen(Baliao acupoint)was 20.34%(59/290).The detected three types of variation were sacral vertebrae number variation(4sacral vertebraes,6sacral vertebraes),fusion variant(lumbosacral fusion,sacrococcygeal fusion,lumbosacral & sacrococcygeal fusion,and lumbosacral fusion & S 4variation)and mixed type.Conclusion Variations of sacral vertebrae including the number and fusion exist in the human body,suggesting an increase of the difficulty of acupoint needling.Since posterior iliac spine does not change generally,it is recommended to be used as a reference point for locating the Baliao acupoint.
Objective To observe the variation of sacral vertebrates and foramen involving the bilateral Shangliao(BL 31),Ciliao(BL 32),Zhongliao(BL 33)and Xialiao(BL 34,Baliao acupoints),so as to provide an anatomic basis of acupoint needling in clinical practice.Methods A total of 290patients[161men and 129 women,mean age and standard deviation,(63.6±13.3)years old and(59.5±13.3)years old,respectively]with intact pelvic structure were recruited in the present study.Computed tomography(CT)scans of intact pelves were taken using a SOMATOM Definition AS 128 and the acquired signals were imported into Siemens Syngo Inspace platform for 3Dreconstruction,followed by identification,classification and analysis of the variation of sacral foramen(Baliao acupoint).Results The total variation rate of posterior sacral foramen(Baliao acupoint)was 20.34%(59/290).The detected three types of variation were sacral vertebrae number variation(4sacral vertebraes,6sacral vertebraes),fusion variant(lumbosacral fusion,sacrococcygeal fusion,lumbosacral & sacrococcygeal fusion,and lumbosacral fusion & S 4variation)and mixed type.Conclusion Variations of sacral vertebrae including the number and fusion exist in the human body,suggesting an increase of the difficulty of acupoint needling.Since posterior iliac spine does not change generally,it is recommended to be used as a reference point for locating the Baliao acupoint.
引文
[1]周惠芬,杨旭,丁曙晴,等.八髎穴(骶后孔)定位、测量与取穴方法研究[J].中国针灸,2013,33(8):703-707.
[2]皇甫谧.针灸甲乙经[M].北京:人民卫生出版社,2006:66.
[3]黄龙祥.世界卫生组织标准针灸经穴定位[M].北京:人民卫生出版社,2010:112-113.
[4]中华人民共和国国家质量监督检验检疫总局.中华人民共和国国家标准《腧穴定位人体测量方法》(GB/T 23237-2009)[M].北京:中国标准出版社,2009:1-32.
[5]胡明华,吴长初,李玉飞,等.4椎骶骨变异1例观测[J].四川解剖学杂志,2012,20(4):106.
[6]冯地忠,孟镔,倪跃,等.骶骨变异1例报告[J].局解手术学杂志,2006,15(1):62.
[7]柯鹏,唐珏,林金勇,等.先天性4椎骶骨并不完全性腰骶移行1例[J].中国临床解剖学杂志,2013,31(4):213-214.
[8]林金勇,王麟尧,柯鹏,等.先天性4骶椎1例考察[J].中国临床解剖学杂志,2013,31(4):199-200.
[9]王龙海,吴成长.八髎穴间宽与髂后上棘间宽的相关性研究[J].现代中医药,2009,29(1):18-19.
[10]汪荣,宋岩峰,张文举.基于CT三维重建的女性次髎穴定位研究[J].针刺研究,2010,35(4):307-310.
[11]陈忠孝,余汝堂,杨新东,等.经骶后孔骶管阻滞的临床应用解剖[J].中国临床解剖学杂志,2008,26(5):503-506.
[12]田顺亮,贺生,范真,等.骶后孔(八髎穴)的临床应用解剖学[J].中国临床解剖学杂志,2002,20(6):454-455.
[13]刘芳稿,王铎,华延令,等.八髎穴的体表定位[J].上海针灸杂志,1982,1(4):35-37.
[14]王玲玲,金洵.重新认识八髎穴[J].南京中医药大学学报,2014,30(1):4-7.
[2]皇甫谧.针灸甲乙经[M].北京:人民卫生出版社,2006:66.
[3]黄龙祥.世界卫生组织标准针灸经穴定位[M].北京:人民卫生出版社,2010:112-113.
[4]中华人民共和国国家质量监督检验检疫总局.中华人民共和国国家标准《腧穴定位人体测量方法》(GB/T 23237-2009)[M].北京:中国标准出版社,2009:1-32.
[5]胡明华,吴长初,李玉飞,等.4椎骶骨变异1例观测[J].四川解剖学杂志,2012,20(4):106.
[6]冯地忠,孟镔,倪跃,等.骶骨变异1例报告[J].局解手术学杂志,2006,15(1):62.
[7]柯鹏,唐珏,林金勇,等.先天性4椎骶骨并不完全性腰骶移行1例[J].中国临床解剖学杂志,2013,31(4):213-214.
[8]林金勇,王麟尧,柯鹏,等.先天性4骶椎1例考察[J].中国临床解剖学杂志,2013,31(4):199-200.
[9]王龙海,吴成长.八髎穴间宽与髂后上棘间宽的相关性研究[J].现代中医药,2009,29(1):18-19.
[10]汪荣,宋岩峰,张文举.基于CT三维重建的女性次髎穴定位研究[J].针刺研究,2010,35(4):307-310.
[11]陈忠孝,余汝堂,杨新东,等.经骶后孔骶管阻滞的临床应用解剖[J].中国临床解剖学杂志,2008,26(5):503-506.
[12]田顺亮,贺生,范真,等.骶后孔(八髎穴)的临床应用解剖学[J].中国临床解剖学杂志,2002,20(6):454-455.
[13]刘芳稿,王铎,华延令,等.八髎穴的体表定位[J].上海针灸杂志,1982,1(4):35-37.
[14]王玲玲,金洵.重新认识八髎穴[J].南京中医药大学学报,2014,30(1):4-7.