经鼻烟窝桡动脉穿刺行经皮冠状动脉介入治疗术的临床解剖

目的：探讨经鼻烟窝桡动脉穿刺行经皮冠状动脉介入治疗术（PCI）的解剖学基础。方法：选取34 具（68侧）成人标本，利用游标卡尺分别测量桡动脉位桡骨茎突上5 cm 及入、出鼻烟窝处断面的外径、内径，测量鼻烟窝桡动脉实际长度和出入点直线距离，观察桡神经浅支分型及其通过鼻烟窝的数量。结果： 距离桡骨茎突上5 cm处桡动脉断面（SA）外径（2.82±0.35）mm、内径（1.99±0.43）mm、管壁厚度（0.42±0.14）mm ；桡动脉入鼻烟窝处断面（SB）外径（2.50±0.35）mm、内径（1.71±0.42）mm、管壁厚度（0.39±0.13）mm ；桡动脉出鼻烟窝处断面（SC）外径（2.23±0.38）mm、内径（1.47±0.43）mm、管壁厚度（0.38±0.13）mm。3 处断面，桡动脉外径、内径任意2 组差异具有统计学意义，管壁厚度差异无统计学意义。同一断面、不同性别间，SB 和SC 处外径的差异均具有统计学意义。同一断面、不同侧别之间相同项目比较差异均无统计学意义，不同侧别及年龄组间鼻烟窝桡动脉弯曲程度比较差异无统计学意义。结论： 本研究比较了桡动脉穿刺点附近3 处断面的解剖学特性，为提高经桡动脉PCI 的成功率提供了有力的解剖学支持。

Clinical anatomy of percutaneous coronary interventionvia radial artery in anatomical snuff-box

Objective To explore the anatomical basis of percutaneous coronary intervention（ PCI） through radialartery puncture in snuff box. Methods Thirty-four specimens（ 68 sides） were selected， and the external diameter（ED）， internal diameter（ ID）， and wall thickness（ WT） at the section 5 cm proximal to the styloid process ofthe radius（ SA）， entrance（ SB）， and exit（ SC） of radial artery in the snuff-box were measured respectively witha vernier caliper. Also， the actual length of the radial artery in the snuff-box， the straight-line distance betweenthe entry and exit points were measured， and the classification of the superficial branches of the radial nervewas observed， and the nerve number passing through the snuff-box was counted. Results The ED， ID and WTwas（ 2.82±0.35） mm，（ 1.99±0.43） mm， and（ 0.42±0.14） mm at SA respectively， was（ 2.50±0.35） mm，（1.71±0.42） mm and（ 0.39±0.13） mm at SB respectively， and was（ 2.23±0.38） mm，（ 1.47±0.43） mm and（0.38±0.13） mm at SC respectively. The difference of ED or ID between any two groups of the above three sectionswas both statistically significant， rather than the WT. The ED at SB or SC between the males and females was bothsignificant statistically. The differences of the same items at the same section between both sides were not significantstatistically. The bending degree of the radial artery in the snuff-box between both sides and age groups had nodifference statistically. Conclusion This study compares the anatomical characteristics of the three sections nearthe puncture point of radial artery and provides strong anatomical support for improving the success rate of PCI viaradial artery.