肩胛骨安全区的解剖

doi:10.16098/j.issn.0529-1356.2017.01.012

摘要/Abstract

摘要：

目的通过解剖学研究，评估各个肩胛骨同一区域的差异，获得一个能有效避免医源性神经损伤的安全区，为施行和改良关节镜手术提供数据参考。方法选取100个保存完好的干肩胛骨，测量肩胛体、关节盂和肩胛上神经的走行路径，用统计学方法对所得数据进行处理和分析。结果肩胛体纵向最长距离 (A)、肩胛体横向最长距离 (B)、关节盂纵向最长距离 (C)、关节盂横向最长距离 (D)与肩胛切迹到盂上结节的距离(E)的皮尔森相关系数分别为：0.797、0.786、0.792、0.687；与冈下窝的后盂缘中线到肩胛冈嵴内侧缘的距离 (F)的皮尔森相关系数分别为：0.368、0.381、0.403、0.396。根据统计学分析，国人的安全区即盂上结节到肩胛切迹的安全距离是2.2cm，冈下窝的后盂缘中线到肩胛冈嵴内侧缘的安全距离是1.3cm。结论对肩胛骨的相关指标进行评估，以便获得安全区以利于手术的进行，避免肩胛上神经的损伤；同时，线性方程预测也应该被应用于获取患者的肩胛上神经的相关解剖学数据。

关键词: 肩胛上神经, 肩胛骨解剖, 医源性损伤, 肩关节镜, 解剖学测量, 人

Abstract:

Objective To assess the differences between different scapulae in the same subject to obtain a safe zone for avoiding iatrogenic nerve lesions, and to provide data reference for the improvement and operation of arthroscopic surgery. Methods Totally 100 well preserved dry scapulae were selected and measured the scapular body, glenoid, and the course of the suprascapular nerve. Data were processed and analyzed by statistical methods. Results The Pearson’s correlation between major ongitudinal axis (A), major transversal axis (B), glenoid major longitudinal axis (C), glenoid major transversal axis (D) and the distance from the supraglenoid tubercle to the scapular notch (E) respectively were 0.797, 0.786, 0.792 and 0.687; between them and the distance from the midline of the posterior glenoid rim to the base of the scapular spine (F) respectively were: 0.368, 0.381, 0.403 and 0.396. According to the results of statistical calculation, the safe zone referring to the whole population proved to be 2.2cm for the distance from the supraglenoid tubercle to the nerve at the scapular notch and 1.3 cm for the distance from the midline of the posterior glenoid rim to the base of the scapular spine. Conclusion It is important to understand the safety zone in the operation to avoid the injury of the suprascapular nerve; therefore, the related indexes of the scapulae should be evaluated, so that as obtain the better entry during the operation. The linear predictors should be used to obtain specific values of the posterosuperior limit in each patient.

张振华王立博崔雯铭温静彭诗琴史紫堉徐高磊. 肩胛骨安全区的解剖[J]. 解剖学报, 2017, 48(1): 65-69.

ZHANG Zhen-hua WANG Li-bo CUI Wen-ming WEN Jing PENG Shi-qin SHI Zi-yu XU Gao-lei. Anatomy of the scapulae safety prediction[J]. Acta Anatomica Sinica, 2017, 48(1): 65-69.

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