以锁骨内侧端最高点为标志行右静脉角部穿刺的应用解剖

Applied Anatomy of the Puncture of Right Venous Angle Marking at the Highest Point of the Sternal End of the Clavicle

目的 研究以“颈锁等腰三角”为新标志的右静脉角穿刺的应用解剖。方法 将 74具成年尸体分为解剖观测组 (2 0具 )和尸体试穿组 (5 4具 )。以锁骨内侧端最高点 (P点 ,锁骨胸上结节 )为标志 ,向上作垂线 (N线 ) ,向外侧作水平线 (T线 ) ,沿锁骨向外上作斜线 (C线 ) ,通过局部解剖确定颈根部大血管与它们投影关系 ,进行了右静脉角部试穿 ,并测量其各项参数。结果 有 95 . 95 %的人 ,双侧锁骨内侧端存在明显的标志性突起即P点。 (2 )大多数人的右静脉角位于锁骨内侧端的稍上方。从右侧“颈锁等腰三角”底边的中、外 1/3交点 ,向锁骨胸上结节穿刺右静脉角部 ,是经颈根部大静脉置管的理想选择。只有不到一半的人 ,在解剖学上 ,存在着临床上作为穿刺标志的胸锁乳突肌三角。结论 以右侧锁骨内侧端最高点 (P点 )确立的“颈锁等腰三角” 。

Objective To locate the new mark of the Right Neck-Clavicle Isosceles Triangle (RNClT) for the right venous angle puncture. Methods Seventyfouradult cadaver were divided into two groups: anatomical group (n= 20) and puncture group (n = 54). The verticle line N and the horizonal line T were drawn from the highest point of the sternal end of the clavicle. (P point), and the line C was drawn from P point along the superior surface of clavicle. Within the area of N line and T line the parameters of neck-root large bloodvessel were anatomized and measured and their projections on skin were observed,and the punctureof the right venous angles was applied. Results There are obivious marking processes at thebilateral sternal ends of the claviclein 95.95% cases which are alled the P points. Most of the right venous angle of the these cadaver locate places just superior to the sternal end of the clavicle. The mark of RNCIT was identified as the best marking for the the right venous anglepuncturein puncture group,here only less than half of the anatomical group. ConclusionThe RNCIT which can be located by the P point and the C line andthe N line is a reliab1e mark for the right venous anglepuncture.