小脑延髓池穿刺和C_(12)侧方穿刺的比较及临床意义

目的:与临床共同探讨小脑延髓池穿刺与C1~2侧方穿刺的解剖学比较及临床意义。方法:经甲醛处理的32具成人尸体标本进行小脑延髓池穿刺与C1侧方穿刺进行解剖观测。结果:经第二颈椎棘突尖端上方2 cm处至小脑延髓池的深度为(3.50±0.54)cm,颈前后径(9.31±1.02)cm,颅前后径(17.25±0.78)cm,与颈前后径之间的自身比例(37.74±0.43)%,回归方程为y=-0.32+0.41x;与颅前后径之间的自身比例为(20.31±0.27)%、回归方程为y=-6.72±0.59x、小脑延髓池深度(0.52±0.27)cm。C1后弓下缘与C2椎弓上缘间有一梭形间隙,最大间径为0.7 cm~1 cm,C12椎弓间隙处的蛛网膜下腔侧方宽度为0.3 cm~0.5 cm。结论:小脑延髓池和C12侧方穿刺都存在解剖结构的复杂性及个体差异,只有结合临床经验和操作技巧,才能安全进行小脑延髓池或C12侧方的穿刺。

Cerebellomedullary cistern and C1～2 Lateral Puncturation Compare of Clinical Meaning

Objective Inquiry into together with the clinic The cranial puncture the C_(1~2) lateral puncmratton ofanatomy compares and clinical meaning.Methods 32 Formaldehyde rxd treated become person the corpsespecimen carry on cranial cerebellomedullary cistern and C_(1~2) lateral puncturation carry on anatomy observation,Results By C_2~cervical spine bbove point 2 cm go to cerebellomedullary cistern depth(3.50±0.54)cm,neckanteroposterior dimension、(9.31±1.02)cm,skull anteroposterior dimension(17.25±0.78)cm,of neck anteroposterior dimension The oneself comparison of its(37.74±0.43)%,regression equationy=-0.32±0.41x:of skullanteroposterior dimension The oneself comparison of its(20.31±0.27)%、regression equation y=-6.72±0.59x、cerebellomedullary cistern depth(0.52±0.27) cm.C_1 behind vertebral arch edge and C_2-vertebral arch edge ap Shuttle form cleft,biggest path 0.7 cm~1 cm,C_(1～2) vertebral arch cleft subarachnoid cavity;subarachnoid spacelateral width 0.3 cm~0.5 cm.Conclusions Cerebellomedullary cistern and C_(1~2) lateral puncturation.All exist anatomic structure complexity and individual difikrence,only-combine clinical experience and manipulate can.The safetycarry on cerebellomedullary cistern of C_(1~2) lateral puncturation.