彩色多普勒超声对针刺“颈臂穴”的临床观察

Clinical observation of the dangerous acupuncturation of "Jing Bi" guided with color Doppler ultrasonography

目的探讨高频超声对"颈臂穴"的局部解剖结构显示及其在针刺过程中的应用价值及指导意义。方法选取"颈臂穴"的两个常用取穴点,在高频超声引导下针刺"颈臂穴",观察行针与得气感传时的超声表现。测量取穴点臂丛神经内径、表皮与胸膜距离、臂丛与胸膜间距离。结果对206名健康志愿者以高频超声观察经外奇穴"颈臂穴",均能显示臂丛神经、含气肺组织、毫针针尖与臂丛神经的关系,并能测量表皮与胸膜距离、臂丛与胸膜间距离及臂丛神经内径。得气时超声表现均为针尖刺及臂丛神经外膜,感传程度、感传位置均与针刺方向及臂丛神经走形有关。在超声引导下针刺"颈臂穴"可以安全地避开肺尖,避免气胸的发生。本组所有受试者均于进针10 s内得到感传,且无气胸发生。结论借助高频超声可以准确观察"颈臂穴"的局部解剖结构。高频超声对临床针刺危险穴具有重要价值及指导意义。

Objective To assess the local anatomy of the ＂Jing Bi＂ with high-frequency ultrasound,and to evaluate the clinical significance of high-frequency ultrasound in acupuncture.Methods A total of 206 healthy subjects were observed with the high-frequency ultrasound.Two common location points of ＂Jing Bi＂ were selected and acupunctured under guidance of high-frequency ultrasound.The sensation of subjects was observed.Brachial plexus diameter,distance between skin and membrana pleuralis,as well as the brachial plexus and the pleura were measured.Results The filiform needle tip to lung,lung tissue and the brachial plexus were all showed,and the brachial plexus diameter,distance between skin and membrana pleuralis,the distance between the brachial plexus and the pleura were obtained.The patients felt when the needle reached the membrane of brachial plexus.All subjects got feeling within 10 seconds after acupuncture,and no pneumothorax occurred.Conclusion The local anatomy of dangerous acupoints can be accurately observed with high-frequency ultrasound.High-frequency ultrasound has important value and significance for acupuncturing the dangerous acupoints.