胸膜顶形态与周围常用穴位关系的临床解剖研究.docVIP

胸膜顶形态与周围常用穴位关系的临床解剖研究 文章编号:0255—2930(2006)05—0346—03 中图分类号:R224.2文献标识码:A ChineseAcupunctureamp;Moxibustion.May.2006,Vo1.26No.5 胸膜顶形态与周围常用穴位关系的临床解剖 研究粜 陈跃吴炳煌谢永财张文光阙庆辉.汤兴华董卫国张家栋 (1.福建中医学院中西医结合系,2.针灸推拿系,福卅l350003;3.福建中医学院附属第二人民医院针灸科) [摘要]目的:探讨正常成人胸膜顶形态与其周围常用穴位针刺安全的关系.方法:采用小号克氏 针标定法和层次解剖法,解剖46具正常成人尸体胸部标本,观测胸膜顶的形态及其变异,胸膜顶周 围常用穴位的安全深度及其与胸膜顶形态的关系等项目.结果:在锁骨上缘观测到胸膜顶投影宽 度等于锁骨内i/3段者占全部标本的32.6,投影宽度大于锁骨内t/3段者占全部标本的 59.8,投影宽度小于锁骨内1/3段且胸膜顶内侧界位于胸锁关节内侧者占全部标本的7.6;观 察到诸如天突,气舍,肩井,定喘厦大杼等通常被认为与胸膜项似乎无关的穴位,按标准的穴位定位 和方向行针,超过一定限度时即能穿过胸膜造成破坏.结论:胸膜顶的位置及其形态特点与上部胸 膜腔周围穴位针刺意外的发生存在解剖学结构上的联系,应引起临床针灸医生的警惕和重视. [主题词]针刺穴位;穴位,背部/解剖学和组织学;胸膜/解剖学和组织学 Clinicallyanatomicstudyontherelationbetweentheformofpleuralcupulaanditssurrounding commonly-usedacupoints CHENYue,WUBing-huang,XIEYong-cai,ZHANGWen—guang.QUEQing-hui,TANGXing-hua, DONGWei-gUO,ZHANGJia-dong(1.DepartmentofIntegratedChineseMedicineandWesternMedieine,2.De— partmentofAcupunctureamp;Massage,FujianCollegeofTCM,Fuzhou350003,China;3.TheSecondPeopleSHos pitalAffiliatedtoFujianCollegeofTCM) ABSTRACTObjectiveToexploretherelationoftheformofpleuralcupulaofthenormaladultwithsafetyofacu— punctureatcommonly-usedaeupointsaroundthepleuralcupula.MethodsThesafedepthforthecommonly-used acupointsaroundthepleuralcupulaandtherelationwiththeformofpleuralcupulawereinvestigatedin46adult corpseswithsmallKirschnerwirelocationandarrangementdissection.ResultsThewidthofthepleuralcupula projectionequaltoclaviclemedial1/3accountedfor32.6ofallthecorpses.andthewidthofthepleuralcupula projeetionmorethanclaviclemedial1/3accountedfor59.8ofallthecorpses,thewidthofthepleuralcupulapro— jectionlessthanclaviclemedial1/3andpleuralcupulamedialmarginlocatedatthesternoclavicularjointmedialac— countedfor7.6ofallthecorpses.TheobservedpointssuchasTiantu(CV22),Qishe(ST11).Jianjing(GB 21),Dingchuan(EX-B1),Dazhu(BL11)whichwereconsideredbenotrelatedtothepleuralcupula.Whenacu— punctureiscarriedoutaccordingtocriteriaofacupointlocationandneedlingdirection,andtheneedleexceededa limit,thepleuralmenbrane