幼儿上矢状窦穿刺的应用解剖学研究

Applied Anatomy of Superior Sagittal Sinus Puncture for Infant

目的 为婴幼儿上矢状窦穿刺输液提供应用解剖学依据.方法 在30具婴幼儿尸体上观测了前囟和上矢状窦的位置、深度、头皮厚度以及穿刺有关注意事项.结果 前囟为正菱形,位于矢状缝前端,前、后角分别距眉间的距离为（5.8±1.8）cm、（9.0±1.4）cm,前囟处从头皮至上矢状窦上壁的厚度为（4.2±1.2）mm;上矢状窦在前囟处偏正中线右侧20例,占68%,偏距为（2.2±0.8）mm,偏中线左侧4例,占12%,偏距为（1.4±0.4）mm、位正中线者6例,占20%;上矢状窦上壁宽为（3.6±0.8）mm,深度为（3.9±0.8）mm.结论 上矢状窦具有位置恒定、窦壁不易塌陷、口径大等特点,是婴幼儿穿刺输液的理想部位.

Objective To provide applied anatomic basis for superior sagittal sinus puncture and infusion for infants. Methods 30 infant corpses were selected to be observed the depth and position of bregma and superior sagittal sinus, the thickness of scalp and cautions for puncture. Results Anterior fontanel was straight rhomboid, and located in anterior sagittal suture, the distance between anterior and posterior angles were（5.8 ± 1.8）cm and（9.0 ± 1.4）cm respectively. In anterior fontanel, the thickness form scalp to superior sagittal sinus was （4.2 ± 1.2） mm; there were 20 cases （68 % ） of superior sagittal sinuses were located in anterior fontanel right of median, the length was（2.2 ± 0.8）mm, 4 （12 % ） cases of superior sagittal sinuses were located in left of median, the length was（1.4 ± 0.4） mm, 6 （20 % ） cases of superior sagittal sinuses were located in median; the width of anterior wall superior sagittal sinus was（3.6 ± 0.8）mm, the depth was（3.9 ± 0.8） mm. Conclusion The superior sagittal sinus possess some properties such as definite position, tough walls of sinus and big bore, it is also against collapse, so it is an ideal position for puncture and transfusion for infant.