超声引导甲状旁腺穿刺的应用解剖  

Applied anatomy of ultrasound-guided puncture of parathyoid gland

作　　者：纪荣明[1] 章建全[2] 姜宗来[1] 程林发[1] 冯皓[1] 汪晓军[1] 

机构地区：[1]第二军医大学解剖学教研室,上海200433 [2]长征医院超声科,上海200003

出　　处：《中国临床解剖学杂志》2002年第1期28-29,共2页Chinese Journal of Clinical Anatomy

摘　　要：目的 :提高甲状旁腺超声引导下介入疗法的成功率和减少穿刺并发症。方法 :在 2 0具成人尸体标本上解剖。观测了甲状旁腺的位置、甲状旁腺与甲状腺上、下动脉吻合支的毗邻关系 ;甲状旁腺的纵径、中部横径和厚度。结果 :2 0例标本共解剖出 65个甲状旁腺、平均每例 3 .2 5个 ,其中上、下甲状旁腺成对出现的为 3 5 % ;成对的上甲状旁腺并单侧下甲状旁腺的为 2 0 % ;成对的下甲状旁腺并单侧上甲状旁腺的为 5 % ,只解剖到上甲状旁腺和下甲状旁腺的分别为 2 0 %。结论 :临床行上甲状旁腺穿刺时 ,穿刺点应距甲状腺侧叶上极下方 16mm和距甲状腺后缘 10mm左右的两点交叉处 ;行下甲状旁腺穿刺时 ,穿刺点应距甲状腺侧叶下极上方 12mm和距甲状腺后缘 10mm左右的两点交叉处进针 ,进针深度约 2 0～ 3 0mm。Objectives:To provide anatomic basis for ultrasound guided puncture of parathyroid gland.Methods:The positions and vertical and transverse diameters of parathyroid glands were observed on 20 adult cadaveric specimens, and its position relationships to the nerves and anastomosis branches of superior thyroid arteries and inferior thyroid arteries were investigated.Results:Sixty five parathyroid glands were identified in this study (averaged 3.25 per specimen).In eight specimens(40%), both the superior and inferior parathyroid glands were single; in another seven specimens (35%), either the superior or the inferior parathyroid gland were sound in pairs; four of the twenty specimens (20%) showed paired superior glands with a single inferior one; in only one specimen(5%), the inferior glands were in pairs and the superior glands were single.The superior and inferior parathyroid glands situated above or below the anastomosis branches of superior and inferior thyroid arteries respectively. The superior parathyroid gland was far from superior laryngeal nerve, and it was 11.6±4.1 mm from the inferior parathyroid gland to the recurrent laryngeal nerve.Conclusions:The detailed parathyroid anatomy in this study can meet the need of clinicians to perform the ultrasound guided parathyroid puncture safely and efficiently.

关 键 词：甲状旁腺 介入治疗 超声引导 应用解剖 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学] R445.1[医药卫生—基础医学]