腘静脉穿刺的应用解剖

Applied anatomy of popliteal vein perforation

目的 :为临床静脉穿刺提供解剖学基础。方法 :在 2 5具经防腐成人尸体 5 0侧下肢标本上 ,模拟静脉穿刺 ,逐层解剖窝 ,观测静脉及其毗邻关系以及穿刺时的进针部位、深度、角度等。结果 :静脉体表投影 :膝关节伸直位 ,髌骨上缘水平线与股二头肌肌腱交叉点向后内侧旁开 1 3± 0 7mm处为A点 ,髌骨下缘水平线与股二头肌肌腱交叉点向后内侧旁开 4 1± 0 5mm处为B点 ,A、B两点之连线即为静脉体表投影。在窝上段从内侧向外侧排列次序为动脉、静脉、胫神经 ,在窝中、下段及出窝后三者的排列趋于由深向浅。结论 :静脉穿刺在AB线中点以上较安全 ,中点以下可能伤及动脉和胫神经 ,不宜穿刺。

Objective:To provide anatomy data for clinic popliteal vein perforation (PVP).Methods:Vein perforation simulation and stratified anatomy on poples were performed on 50 lower extremities specimens of 25 antiseptic adult corpses,popliteal vein (PV),its adjacent relations,region,depth and angle in perforation were all observed.Results:PV body surface projection,when knee joint was in extension level,A was located in 1.3±0.7 mm posteromedial crossing point of scutum super edge level line and musculotendon of biceps muscel of thigh,and B was 4.1±0.5 mm posteromedial crossing point of scutum sub edge level line and musculotendon of biceps muscle of thigh.The line between A and B was PV body surface projection.In epimere poples from the medial to the lateral were popliteal artery,popliteal vein and tibial nerve,ranging from depth to surface in middle,hypomere and external poples.Conclusion:PVP is safe above the middle point of AB line and ist't suitable below it,because it may hurt popliteal artery and tibial nerve.