儿童胸骨针灸的潜在危险因素——胸骨骨化中心的MSCT研究  

Potential Risk Factors for Sternal Acupuncture in Children:MSCT Study of the Sternal Ossification Center

作　　者：崔雪 王君霞[1] 李瑞光 马得廷[1] CUI Xue;WANG Junxia;LI Ruiguang(Department of Radiology,Tai'an City Central Hospital,Shandong First Medical University&Shandong Academy of Medical Sciences,Tai’an,Shandong Province 271000,P.R.China)

机构地区：[1]泰安市中心医院(山东第一医科大学附属泰山医院)医学影像中心,271000

出　　处：《临床放射学杂志》2021年第10期1983-1987,共5页Journal of Clinical Radiology

摘　　要：目的探讨儿童胸骨发育的多层螺旋CT(MSCT)表现特征,为儿童胸骨针灸穿刺的安全性提供参考依据。方法回顾性分析344例患者(男204例,女140例)的MSCT表现,年龄1个月~15岁,平均(5.31±3.92)岁。观察胸骨区华盖穴、紫宫穴、玉堂穴、膻中穴、中庭穴以及鸠尾穴,各穴位对应部位的骨化方式和分布,统计胸骨各部多骨化中心或未骨化者毗邻组织。结果344例胸骨中,华盖穴对应胸骨柄,含有2个以上骨化中心44例(12.8%),后方毗邻胸腺最多,为36例(81.8%),其次为右肺5例(11.4%)。紫宫穴对应胸骨体第一节:含有2个骨化中心仅1例(0.03%),后方毗邻心包。玉堂穴对应胸骨体第二节:含有2个骨化中心15例(4.4%),后方毗邻右肺最多,为6例(40%),其次为胸腺4例(26.7%)。膻中穴对应胸骨体第三节:未骨化8例(2.3%),含有2个骨化中心69例(20.5%),后方毗邻右肺最多,为34例(49.3%),其次为心包33例(47.8%)。中庭穴对应胸骨体第四节:未骨化186例(54.1%),含有2个骨化中心31例(19.6%),后方毗邻心包最多,为146例(69.4%),其次为右肺71例(30.6%)。鸠尾穴对应剑突,未骨化175例(50.9%),后方毗邻心包65例(37.1%),右肺59例(33.7%),膈肌51例(29.1%)。结论儿童胸骨的发育具有多样性,对针灸有潜在的危险。中医师在儿童胸骨针灸过程中应考虑到胸骨骨化中心的发育,有利于避免针灸不当造成的严重并发症。Objective To investigate the characteristics of MSCT in children sternum development,and to provide anatomical basis for the safety of sternum acupuncture and puncture in children.Methods MSCT findings of 344 patients(male,204,female,140),ranging from 1 month to 15 years old,were retrospectively analyzed.Observed the ossification mode and distribution of the corresponding parts of Huagai,Zigong,Yutang,Tanzhong,Zhongting and Jiuwei acupoints in the sternum region,and counted the multiple ossification centers or adjacent tissues of the unossified in each part of the sternum.Results Among 344 cases of sternum,44 cases(12.8%)had more than 2 ossification centers in Huagai acupoint corresponding to sternum stalk,36 cases(81.8%)had the most posterior adjacent thymus,followed by 5 cases(11.4%)had the right lung.Zigong acupoint corresponding to the first segment of sternum body:there were 2 ossification centers in only 1 case(0.03%),and the posterior area was adjacent to the pericardium.Yutang acupoint corresponds to the second segment of the sternum body:15 cases(4.4%)contained 2 ossification centers,6 cases(40%)were posterior adjacent to the right lung,followed by 4 cases(26.7%)of the thymus gland.In the third segment of sternum body,there were 8 cases(2.3%)without ossification,69 cases(20.5%)with 2 ossification centers,34 cases(49.3%)adjacent to the right lung posterior,followed by 33 cases(47.8%)pericardium.Zhongting acupoint corresponding to the fourth segment of sternum body:186 cases(54.1%)had no ossification and 31 cases(19.6%)had 2 ossification centers.Posterior adjacent pericardium was the most common(146 cases,69.4%),followed by right lung(71 cases,30.6%).Jiuwei point corresponded to xiphoid process,and there were 175 cases(50.9%)without ossification.The posterior pericardium was adjacent in 65 cases(37.1%),the right lung in 59 cases(33.7%),and the diaphragm in 51 cases(29.1%).Conclusion In children,the development of the sternum is variable and potentially dangerous to acupuncture.The development of sternal os

关 键 词：胸骨 发育 针灸 儿童 穴位 体层摄影术 X线计算机 

分 类 号：R246.4[医药卫生—针灸推拿学]