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多层螺旋CT在骶管阻滞中的临床价值

[Clinical value of multislice spiral CT in caudal block].

作者信息

Zhou Feng, Hu Ba-sheng, Zhang Zhong, Wen Ge

机构信息

Department of Anesthesiology, First People's Hospital of Yueyang, Yueyang 414100, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2006 May;26(5):683-5.

Abstract

OBJECTIVE

To explore a new method for body surface orientation of the puncture site, determination of the direction of the needling and puncture depth for caudal block.

METHODS

Three-dimensional reconstruction of the pelvis was performed in 8 cases for measuring the distances between the sacral hiatus and the planned site of anesthetic delivery and the size of the sacral hiatus. After image processing with the technique of shaded surface display (SSD), the shapes of sacral hiatus and sacral tube were evaluated.

RESULTS

Three-dimensional reconstruction of the pelvis in the 8 cases allowed clear view from any directions of the sacral hiatus and sacral tube and accurate measurement of the size of the sacral hiatus. After simulated cutting of half of the rumpbone, the distances between the sacral hiatus and the drug injection site were accurately measured. With these measurements, accurate preoperative localization of the puncture site on the skin was achieved and the anesthesia was successful in all the cases.

CONCLUSIONS

This technique can provide accurate data for localization of the puncture site on the skin and determination of the direction of the needling and the puncture depth for caudal block to increase the successful rate of anesthesia, lower the operative risks and allow simulated operative training.

摘要

目的

探索一种用于骶管阻滞穿刺部位体表定位、进针方向确定及穿刺深度测定的新方法。

方法

对8例患者进行骨盆三维重建,测量骶管裂孔与计划给药部位之间的距离以及骶管裂孔的大小。采用表面阴影显示(SSD)技术进行图像处理后,评估骶管裂孔和骶管的形态。

结果

8例患者的骨盆三维重建能够从任何方向清晰观察骶管裂孔和骶管,并准确测量骶管裂孔的大小。在模拟切除一半尾骨后,准确测量了骶管裂孔与药物注射部位之间的距离。通过这些测量,实现了术前在皮肤上对穿刺部位的精确定位,所有病例麻醉均成功。

结论

该技术可为骶管阻滞穿刺部位在皮肤上的定位、进针方向及穿刺深度的确定提供准确数据,以提高麻醉成功率、降低手术风险并可进行模拟手术训练。

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