摘要
目的探讨妊娠因素对患者两侧髂嵴最高点连线（T线）与脊柱对应位置的影响。方法选择产科及妇科住院患者，ASA分级Ⅰ或Ⅱ级，分为妊娠组（P组）和非妊娠组（NP组）。患者取侧卧位，背部与手术床呈垂直位，双手抱膝使双下肢股骨线与脊柱呈约90°角。确定两侧髂嵴最高点，用钢丝硬膜外导管做一连线即T线，再沿上侧（非卧侧）髂嵴最高点做与地面的垂线即T′线，行超声检查，记录T线、T′线与棘突和棘突间隙的对应位置。结果完成病例共计1 763例，P组905例，NP组858例。与NP组比较，P组T线位于L3棘突和L3，4棘突间隙的比率升高（P〈0.05）。与T′线比较，P组T线位于L2，3棘突间隙、L3棘突的比率降低，位于L4棘突、L4，5棘突间隙、L5棘突的比率升高，NP组T线位于L3棘突和L2，3、L3，4棘突间隙的比率降低，位于L4棘突和L4，5棘突间隙的比率升高（P〈0.01）。结论妊娠患者T线与脊柱对应位置高于非妊娠患者。
ObjectiveTo investigate the effect of the pregnancy factor on the line drawn between the highest points of the two iliac crests （T line） corresponding to the vertebral level in a multicenter clinical comparative study.MethodsHospitalized patients selected from the obstetric department or gynecological department, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, were divided into pregnancy group （group P） and non-pregnancy group （group NP）. The patients were placed in the lateral position with their back vertical to the bed surface, the patient′s thighs were at an angle of approximately 90 degrees to the trunk, and hip flexion was employed by flexing the patient′s knees to the chest.To determine the highest points of the two iliac crests, a line （T line） was drawn between the highest points using a wire-reinforced epidural catheter.And another vertical line （T′ line） was made between the highest point of the iliac crest on the upper side （not the side in the lateral position） and the ground.Ultrasonography was performed to identify and record the level of T line and T′ line corresponding to the spinous process and lumbar interspace.ResultsA total of 1 763 cases completed the study, and there were 905 cases in group P, and 858 cases in group NP.Compared with group NP, the rate of T line at L3 spinous process and L3, 4 interspace was significantly increased in group P （P〈0.05）. Compared with T′ line, the rate of T line at L2, 3 interspace and L3 spinous process was significantly decreased, and the rate of T line at L4 spinous process, L4, 5 interspace and L5 spinous process was significantly increased in group P, and the rate of T line at L3 spinous process, L2, 3 interspace and L3, 4 interspace was significantly decreased, and the rate of T line at L4 spinous process and L4, 5 interspace was significantly increased in group NP （P〈0.01）.ConclusionThe level of T line corresponding to the vertebral level is significantly higher in the pregnant patients
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2016年第11期1302-1305,共4页
Chinese Journal of Anesthesiology
基金
北京市卫生和计划生育委员会科技成果和适宜技术推广项目（TG-2014-12）
首都医科大学附属北京妇产医院中青年学科骨干培养专项（fcyy201426）
