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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (06) : 640 -643. doi: 10.3877/cma.j.issn.1674-392X.2022.06.007

临床论著

腹横肌的CT解剖学及其在腹横肌平面阻滞的临床意义
郭宏坤1, 孟岩2, 马自达3, 孙少川3, 孙中伟3,†()   
  1. 1. 250013　济南，山东第一医科大学
    2. 250013　济南市中心医院手术麻醉科
    3. 250013　济南市中心医院胃肠外一科
  • 收稿日期:2022-04-24 出版日期:2022-12-18
  • 通信作者: 孙中伟
  • 基金资助:
    山东省老年医学学会2021年科技攻关计划项目(LKJGG2021Z004); 2021年济南市卫生健康委员会科技计划项目(2021-1-04)

CT-based anatomical measurement of transversus abdominis and its clinical significance in transversus abdominis plane block

Hongkun Guo1, Yan Meng2, Zida Ma3, Shaochuan Sun3, Zhongwei Sun3,†()   

  1. 1. Shandong First Medical University, Jinan 250013, China
    2. Department of Surgical Anesthesiology, Jinan Central Hospital, Jinan 250013, China
    3. The First Department of Gastrointestinal Surgery, Jinan Central Hospital, Jinan 250013, China
  • Received:2022-04-24 Published:2022-12-18
  • Corresponding author: Zhongwei Sun
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引用本文：

郭宏坤, 孟岩, 马自达, 孙少川, 孙中伟. 腹横肌的CT解剖学及其在腹横肌平面阻滞的临床意义[J/OL]. 中华疝和腹壁外科杂志(电子版), 2022, 16(06): 640-643.

Hongkun Guo, Yan Meng, Zida Ma, Shaochuan Sun, Zhongwei Sun. CT-based anatomical measurement of transversus abdominis and its clinical significance in transversus abdominis plane block[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(06): 640-643.

目的

探讨腹横肌在不同人群腹壁层面的厚度变化及其在腹横肌平面阻滞的临床意义。

方法

回顾性分析2021年1-12月济南市中心医院胃肠外一科60例住院患者的临床及CT资料。用CT影像LIS系统测量不同水平腹横肌和腹壁厚度，分析腹横肌和腹壁厚度及其影响因素。

结果

脐水平和髂前上棘水平腹横肌厚度在不同体质量指数（BMI）、性别和年龄之间差异无统计学意义（P>0.05）；脐水平与髂前上棘水平腹壁厚度在不同性别、BMI之间差异均有统计学意义（P<0.05），在不同年龄之间差异无统计学意义（P>0.05）。

结论

腹横肌厚度在不同人群腹壁层面相对恒定，对腹腔镜辅助腹横肌平面阻滞具有重要参考意义。

关键词: 腹横肌, 神经阻滞, 腹腔镜, 解剖学, 体层摄影术，X线计算机
Objective

To investigate the thickness variation of the transversus abdominis at the abdominal wall level in different populations and its clinical significance in the transversus abdominis plane block.

Methods

The clinical and CT data of 60 inpatients in the First Department of Gastrointestinal Surgery, Jinan Central Hospital from January to December 2021 were retrospectively analyzed. The thickness of transverse abdominis and abdominal wall at different levels were measured using CT image LIS system. The thickness of transverse abdominis and abdominal wall and their influencing factors were analyzed.

Results

There was no significant difference in the thickness of the transversus abdominis at the level of the umbilicus and the anterior superior iliac spine between different body mass index (BMI), gender and age (P>0.05). There were significant differences in the thickness of the abdominal wall at the level of the umbilicus and the anterior superior iliac spine between different gender and BMI (P<0.05), but no significant differences between different ages (P>0.05).

Conclusion

The thickness of the transversus abdominis is relatively constant at the abdominal wall level in different populations, which has important reference significance for laparoscopic-assisted transversus abdominis plane block.

Key words: Transversus abdominis, Nerve block, Laparoscopes, Anatomy, Computer tomography
图2 2A、2B髂前上棘水平测量：腹横肌厚度5.64 mm
表1 不同性别、年龄、体质量指数患者不同测量水平腹横肌和腹壁厚度差异性比较（mm，±s）
项目 性别 t P 年龄(岁) F P
男(n=32) 女(n=28) 18~40(n=29) 41~60(n=15) ≥61(n=16)
腹横肌 脐水平 2.739±0.486 2.645±0.517 0.731 0.468 2.702±0.454 2.795±0.507 2.588±0.576 0.666 0.518
髂前上棘水平 4.993±0.938 5.082±1.077 -3.410 0.734 4.915±0.863 5.203±1.072 5.094±1.181 0.443 0.644
腹壁 脐水平 28.623±5.670 32.854±7.797 -2.374 0.022 30.967±6.044 32.085±7.384 28.533±8.220 1.072 0.349
髂前上棘水平 25.537±7.551 32.157±9.490 -2.961 0.005 26.667±7.458 32.308±8.346 28.725±11.564 1.977 0.148
项目 体质量指数 F P
偏瘦(n=7) 正常(n=25) 超重(n=20) 肥胖(n=8)
腹横肌 脐水平 2.613±0.521 2.725±0.443 2.555±0.523 3.023±0.507 1.878 0.144
髂前上棘水平 5.079±0.858 4.903±0.909 5.109±1.023 5.220±1.403 0.268 0.818
腹壁 脐水平 27.820±2.243 27.128±5.813 33.760±5.877 35.940±9.437 6.903 0
髂前上棘水平 21.900±2.742 23.517±6.177 32.890±8.141 39.811±6.552 17.278 0
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