摘要
目的 :研究中国人侧入法腰部硬膜外穿刺角度及其与年龄、身高、性别及肥胖的关系。方法 :5 9例病人 (I组 )实际测量穿刺角度 ,计算均数及其与病人年龄、身高的相关系数 ,并对男、女均数进行分析比较。同时计算除去孕妇后 38例病人穿刺角度与体重 /身高2 的相关系数。另外 6 4例病人 (Ⅱ组 )测量正中穿刺时皮肤至硬膜外间隙距离 ,利用三角函数计算侧入法穿刺角度。结果 :I组穿刺角度为 (6 2 .6 3± 4.2 5 )度 ,Ⅱ组为 (6 6 .5 5± 0 .5 0 )度〔皮肤至硬膜外间隙距离为 (3 .46± 0 .0 5 )cm〕。I组穿刺角度与年龄 (r =- 0 .0 2 )和身高 (r =0 .0 5 )无相关性 ,男性 (6 3 .89± 3.6 0 )度与女性 (6 2 .0 7± 4.43)度比较也无显著性差异 (u =1.6 7,P >0 .0 5 )。 38例病人穿刺角度与体重 /身高2 呈正相关 (r=0 .6 8,t =5 .5 7,P <0 .0 1)。结论 :中国人侧入法腰部硬膜外穿刺角度宜选择 6 5度左右。该角度与年龄、身高和性别无关 。
Objective:This study was designed to investigate the angle formed by side puncture to epidural space in waist and the relations between the angle and age, height, gender and corpulence respectively.Methods:The data were collected from the medical records of 59 patients who received side puncture to epidural space in waist(group I) and the angles of puncture were measured. Arithmetic mean of the angle was obtained.Coefficient of correlation between the angle and age, the angle and height were calculated. The mean of the male (M) was compared with that of the female (F) by u test. Meanwhile,the mean of the puncture angles of 38 patients in group I except pregnant women was obtained and the coefficient of correlation between it and BMI (Weight/Hight 2) was also calculated. In addition,data of distance from skin to epidural space were collected from the medical records of 64 patients(group Ⅱ) who received middle puncture to epidural space. Theoretical data of angles formed by side 1.5 cm puncture were calculated by means of trigonometry.Results:Mean angle of group I was (62.63±4.25) .Mean angle of group Ⅱ was (66.55±0.50) 〔Distance from skin to epidural space was (3.46±0.50 cm) 〕.Mean angle of group I was neither correlative with age(r=-0.02)nor with height(r=0.05). M(63.89±3.60) was not significantly different(u=1.67,P>0.05)from F(62.06 ±4.43),but mean angle of 38 patients was correlative with Weight/Hight 2(r=0.61,t=4,63,P<=0.01).Conclusion:It is suitable that angle formed by side puncture to epidural space in waist is chosen about 65 in Chinese patients regardless of age,height and gender,but the angle is positive correlative with corpulence(Weight/Hight 2).
