CT下经完骨穴穿刺面神经方向研究  

Study on Direction of Facial Nerve Puncture Through Wangu(GB12)Acupoint Under CT

作　　者：刘莹莹 吕子旭 于文颜 张运良 LIU Yingying;LYU Zixu;YU Wenyan;ZHANG Yunliang(Zibo First Hospital,Zibo 255200,China;Shandong Second Medical University,Weifang 261042,China;Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Zibo Central Hospital,Zibo 255020,China)

机构地区：[1]淄博市第一医院,山东淄博255200 [2]山东第二医科大学,山东潍坊261042 [3]山东中医药大学,山东济南250355 [4]淄博市中心医院,山东淄博255020

出　　处：《山东中医杂志》2024年第8期861-865,893,共6页Shandong Journal of Traditional Chinese Medicine

摘　　要：目的:通过CT影像多平面重建,模拟经完骨穴向瞳孔方向穿刺路径,以茎乳孔为参照对象,探讨经完骨穴穿刺面神经的可行性与安全性。方法:选择扫描范围包含颅底的CT影像24例为观测样本,多平面重建后,设计穿刺路径,统计模拟穿刺线成功穿刺至茎乳孔附近的例数并测量与茎乳孔直线距离,观察茎乳孔与周围解剖结构位置关系。结果:在24例观测样本横断面上模拟穿刺,共得到穿刺路径48条,模拟穿刺线行经均未见骨性结构,穿刺成功率100%。经过计算得到模拟穿刺线与茎乳孔外口的空间直线距离,最短1.55 mm,最长10.35 mm,平均(5.03±1.93)mm,左右两侧直线距离差异无统计学意义(P>0.05),不同性别被观测者直线距离差异无统计学意义(P>0.05)。模拟穿刺路线均未途经颈静脉孔、颈动脉管外口。结论:经完骨穴向瞳孔方向穿刺至面神经附近是安全可行的。Objective:To explore the feasibility and safety of facial nerve puncture through Wangu(GB12)acupoint by using multi-planar reconstruction of CT images to simulate the puncture path to the pupil direction,taking stylomastoid foramina as the reference object.Methods:24 cases with CT scans that included the base of the skull were selected as the observation samples.After performing multi-planar reconstruction,a puncture path was designed,and the number of simulated puncture lines that successfully penetrated the stylomastoid foramina near the stylomastoid suture was counted,and the perpendicular distance to the stylomastoid foramina was measured.The distance relationship between the stylomastoid foramina and the surrounding anatomical structures was observed.Results:A total of 48 puncture paths were obtained on the cross section of 24 observed samples.No bone structure was found in the simulated puncture lines,and the puncture success rate was 100%.The spatial linear distance between the simulated puncture line and the outer orifice of the stylomastoid foramina was calculated,the shortest was 1.55 mm,the longest was 10.35 mm,and the average was(5.03±1.93)mm.There was no statistical difference between the left and right linear distance(P>0.05),and there was no statistical difference between the male and female linear distance(P>0.05).None of the simulated puncture routes passed through the jugular foramen or the external orifice of the carotid artery.Conclusion:It is safe and feasible to puncture facial nerve through Wangu(GB12)acupoint to the pupil direction.

关 键 词：面神经 完骨穴 针刺 针刺角度 针刺深度 电子计算机断层扫描 

分 类 号：R224.2[医药卫生—中医基础理论]