| Objective:Providing anatomical basis for the Yaoshu Acupoint Anesthesia through research to Applied Anatomy of Yaoshu Acupoint. Evaluated the feasibility and Clinical value of Ultrasound as a Guiding Tool for Yaoshu Acupoint Anesthesia through comparison, expecting to explore a new assisted positioning methods for it.Methods:Part one:Select10integral sacrococcygeal cadavers of adult(male:7, female:3)and dissect the level to the path of Yaoshu Acupoint Anes-thesia,observe,record and analyze the local hierarchy,internal composition and variability of Yaoshu Acupoint.Part two:Select60cases of the anorectal disease meting the inclusion criteria,divided randomly into the Ultrasound-guided puncture group(hereinafter referred to as the test group) and traditional blind puncture group(hereinafter referred to as the control group),30cases in test group and30cases in control group. Ultrasound is used to position and real-time guided the needle into Yaoshu Acupoint in the test group, the control group,we take advantage of the landmarks and the loss of resistance to locate the Yaoshu Acupoint.Observe the differences of preparation time before puncture, puncture time,number of puncture attempt,success rate of disposable puncture,narcotic effects,adverse reactions,and Postoperative Uroschesis,come to a conclusion by recording data and analyzing by statistics. Results:Part one:There is a layer of translucent and shiny connective tissue membrane closes to the thick and tough sacrococcygeal ligament through that we can see yellow adipose connective tissue. Sacrococcygeal nerve (S5, coccygeal nerve), filum terminale, and a large number of venous plexus are wrappped the frout wall part of adipose connective tissue. Adipose connective tissue is tightly connected together and fixed to the anterior wall of sacral hiatus by large amounts of fiber bundles included it. A bony bulge on the anterior wall of sacral hiatus is finded in a male specimens and make Sacrococcygeal nerve, filum terminale out of there normal position.Part two:In the test group,clear ultrasound images for Yaoshu Acupoint can be get and we can pucture under the real-time guidance of Ultrasound. It is no significant difference between the two groups that puncture time, narcotic effects,and Postoperative Uroschesis (P>0.05).The test group spend longer preparation time before puncture than the control group,there difference is significant (P<0.05).The mean number of puncture respectively are (1.43±0.626) times and(2.00±1.114) times,and the one-time success rate respectively are76.7%and40.0%, There was significant difference between two groups. The test group have an advantage between the number of puncture and the one-time success rate comparing to the control group.Conclusion:Part one:①There are two important structures blow sacro-coccygeal ligament,one is the translucent and shiny connective tissue membrane,another is an integrated body mainly composed of adipose tissue.The two layer structures and sacrococcygeal ligament are Closely connected together and form a functional unit.②The substance of Yaoshu Acupoint Anesthesia,on the one hand,is connected with the infiltration of local anesthetic in the Acupoint area and act on the sacrococcygeal nerve,on the other hand may be associated with a series of induction and reaction caused by stimulus of puncture needlles to Acupoint and drug oppression.③one of the reasons of incomplete anesthesia and hemi-anesthesia may be caused by the bony bullge of the anterior wall of the sacral hiatus.Part two:Ultrasound Guidance in Yaoshu Acupoint Anesthesia is feasible and valuable because of that it can reduce the number of puncture, raise success rate of disposable puncture,reduce the occurrence of adverse reactions. |
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