肩中俞与大杼穴的解剖学结构与安全针刺的深度及角度

目的 探讨肩中俞与大杼穴的解剖学结构与针刺深度、角度的关系.方法 经福尔马林固定的成年人尸体46具,男性30具,女性16具,采用钢针标定法和层次解剖法进行研究.结果 肩中俞向下直刺的解剖结构依次是皮肤、浅筋膜、斜方肌、菱形肌、颈夹肌、竖脊肌、胸膜上膜、胸膜顶;大杼穴向下直刺的解剖结构依次是皮肤、浅筋膜、斜方肌、菱形肌、上后锯肌、颈夹肌、竖脊肌、肋提肌、肋间内膜、肋胸膜.向下直刺的平均危险深度:肩中俞为60.60mm,大杼穴为55.93mm.结论 肩中俞和大杼穴向下直刺的深度应控制在＜42mm.

Safe Depth for Needling "Jianzhongshu" and "Dazhu" Point

Objective To probe into the anatomic structure and safe needling depth and angle of "Jianzhongshu" and "Dazhu" point.Methods Forty-six adult corpses were selected.Among them,30 were ma1e and 16 female.Layer anatomy method were used to study the anatomic structure and suitable needle-insertion depth.Results The anatomic structures of "Jianzhongshu" for perpendicular insertion downward were skin,superficial fascia,trapezius,rhomboideus,splenius cervicis,erector spinae,suprapleural membrane and cupula of pleura in order.The anatomic structures of "Dazhu" were skin,superficial fascia,trapezius,rhomboideus,upper posterior serratus,splenius cervicis,erector spinae,levator ribs,internal intercostal membrane and costal pleura in order.The mean dangerous depth for perpendicular insertion downward was 60.60 mm of "Jianzhongshu" and 55.93 mm of "Dazhu".Conclusion For safety,it is suggested that the depth for perpendicular needling of "Jianzhongshu" and "Dazhu" is within 42 mm in adult.