Poland G A, Borrud A, Jacobson R M, McDermott K, Wollan P C, Brakke D, Charboneau J W
Mayo Vaccine Research Group, Clinical Pharmacology Unit, Rochester, MN 55905, USA.
JAMA. 1997 Jun 4;277(21):1709-11.
To measure deltoid fat pad thickness and determine the optimal needle length for deltoid intramuscular immunization in healthy adults.
DESIGN, SETTING, AND PARTICIPANTS: Prospective study of 220 healthy health care workers (126 women, 94 men) at the Mayo Medical Center, Rochester, Minn.
Deltoid fat pad thickness determined by high-resolution ultrasound scanning, weight, height, and mid-deltoid arm circumference.
We found a highly significant difference between women and men in deltoid fat pad thickness, with women having a thicker deltoid fat pad (11.7 vs 8.3 mm; P<.001). Women had a greater deltoid skin-fold thickness than men (34.7 vs 17.2 mm, P<.001) and an equal body mass index. According to the ultrasound findings, a standard 16-mm (5/8-in) needle would not have reached 5 mm into muscle in 17% (16/94) of men and 48.4% (61/126) of women in this study.
Among healthy adults of the age range we studied, the following needle lengths appear to be appropriate for true deltoid intramuscular immunization: For men across the weight ranges we studied (59-118 kg), use of a 25-mm (1-in) needle would result in at least 5 mm of muscle penetration in all subjects. For women who weighed less than 60 kg, a 16-mm (5/8-in) needle would be sufficient to achieve muscle penetration of 5 mm. For women between 60 and 90 kg, a 25-mm (1-in) needle would be sufficient, and women greater than 90 kg would require a 38-mm (1.5-in) needle to ensure intramuscular administration.
测量三角肌脂肪垫厚度，并确定健康成年人三角肌肌内免疫接种的最佳进针长度。
设计、地点和参与者：对明尼苏达州罗切斯特市梅奥医学中心的220名健康医护人员（126名女性，94名男性）进行的前瞻性研究。
通过高分辨率超声扫描测定三角肌脂肪垫厚度、体重、身高和三角肌中部臂围。
我们发现男性和女性的三角肌脂肪垫厚度存在高度显著差异，女性的三角肌脂肪垫更厚（11.7对8.3毫米；P<0.001）。女性的三角肌皮褶厚度大于男性（34.7对17.2毫米，P<0.001），且体重指数相同。根据超声检查结果，在本研究中，标准的16毫米（5/8英寸）针头在17%（16/94）的男性和48.4%（61/126）的女性中无法刺入肌肉达5毫米。
在我们研究的年龄范围内的健康成年人中，以下进针长度似乎适合真正的三角肌肌内免疫接种：对于我们研究的体重范围内的男性（59 - 118千克），使用25毫米（1英寸）的针头在所有受试者中至少能刺入肌肉5毫米。对于体重小于60千克的女性，16毫米（5/8英寸）的针头足以刺入肌肉5毫米。对于体重在60至90千克之间的女性，25毫米（1英寸）的针头就足够了，而体重超过90千克的女性则需要38毫米（1.5英寸）的针头以确保肌内注射。
