成人股外侧肌比例法注射的应用分析

The application of adult musculus vastus lateralis injection in proportion

目的：分析一种新的股外侧肌注射安全区比例确定法（比例法）的应用效果。方法：将200例患者分成传统法组和比例法组各100例,按照文献提供的股外侧肌注射要求,对他们的安全范围及不良反应进行比较分析。结果：传统法组8例出现股外侧肌神经下支刺激症状,比例法组未出现神经血管损伤症状。传统法组的安全区确定难于比例法组,而且在女性患者中明显较小。传统法组出现硬结和影响运动的疼痛明显高于比例法组（P〈0.01）,2组均未出现脓肿等严重感染性并发症。传统法组和比例法组均未出现明显肌肉坏死挛缩情况。结论：比例法最佳安全区（伸直腿后股部外侧上2/5与下1/5区域）确定准确易掌握,扩大安全区（伸直腿后股部外侧3/5区域）注射深度严格控制在皮肤和浅筋膜厚度加1.0~1.2 cm是很安全的,且对注射深度的要求有效降低了硬结、疼痛和感染等并发症的发生。

Objective：To analyze the application of a new safe adult musculus vastus lateral injection（proportion method）.Methods：Two hundred patients were divided into the traditional treatment group and the proportion treatment group according to the musculus vastus lateral injection provided by literature.The application safety zone and side effect were analyzed contrastively.Results：The irritative musculus vastus lateral inferior neuroligic symptom was present of the 8 cases of traditional treatment group,while the neurological symptoms of vascular injury was not confirmed in proportion treatment group.It was more difficult to determine the safety zone in the traditional treatment group,especially which in the female patients was significantly smaller.The traditional treatment group in which appearred sclerosis and pain impacting the movement was significantly higher than the proportion treament group（P0.01）,however there were not abscesses and other serious infectious complications in both groups.There were no apparent contracture of muscle necrosis in the traditional treatment group and the proportion treatment group.Conclusions：The best safety zone（abducting legs,between above 2/5 and the below 1/5 in the lateral thigh region） of the proportion method group is accurate and easily mastered.In the safe zone（abducting legs,lateral thigh below 3/5 regions）,increasing 1.0-1.2 cm of the injection depth of the skin and superficial fascia thickness is safe.The proportion method can reduce the induration,pain and infection complications.