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前、后由囟刺术是对新生儿在疾病诊断时,于其他部位静脉难以采集血液,而从前、后囟进针,于上矢状窦内采血检查的一项技术.为适应护理应用解剖学教学,我们制作了前、后囱穿刺术的教学标本,此标本以突出穿刺部位、穿刺角度、穿刺深度和穿经层次为重点内容,引导学员在理解头颅结构形态的基础上,学习并掌握前、后囟穿刺术的操作要点 现将标本的设计、制作方法介绍如下.l材料与方法(1)用经防腐固定出生后l～2个月的婴尸.平下颌下缘截取下头颅材料.(2)剔去头发,再按下列步骤去掉左侧颅顶部头皮、颅骨和脑组织,暴露大脑镰和上矢状窦.①由左侧眉弓中点距正中矢状线4～5 mm并与之平行向后切至枕外隆凸稍左侧,再由左侧眉弓沿水平方向切至枕外隆凸稍左侧,去除颅顶部左侧份的头皮、颅骨及左侧大脑半球,显露大脑镰和小脑幕等.②去掉上矢状窦的左侧壁,暴露上矢状窦腔,以便显示穿刺的深度:于前囱平行矢状切面向外侧角呈“阶梯”式由浅人深剥制出浅筋膜、帽状腱膜及囟的膜性结构.每层保留3mm宽,以显示颅外的软组织层次.用两支9号针头,一支由前囟后角处进针,针尖指向眉间,与头皮呈450角刺人上矢状窦内,刺入深度为4～5mm左右;另一支于后囟正中进针,针尖指向前上方,与头皮呈 35°～40°角,刺入上矢状窦内,刺入
Before and after the fontanel is a newborn in the diagnosis of the disease, other parts of the vein is difficult to collect blood, and the former, the posterior fontanelle needle, the superior sagittal sinus blood sampling in a technique to adapt to the application of nursing anatomy In teaching, we made teaching samples of front and rear chimney punctures. The specimens were mainly focused on puncture site, puncture angle, puncture depth and puncture level, and guided students to understand and understand the structure of skull. The operation point of the anterior and posterior fontanelle puncture now the specimen design, production methods are described as follows.l Materials and methods (1) with a fixed antiseptic l ~ 2 months after the birth of the baby cut the mandibular lower edge of the lower edge of the material (2) Remove the hair, and then remove the scalp, skull and brain tissue at the top of the left skull and expose the falx and superior sagittal sinus according to the following steps: ① From the middle point of the left eyebrow arch 4 ~ 5 mm And parallel to the back cut to the pillow slightly left side of the bulge, and then from the left eyebrow horizontally along the lateral incision to the left slightly to remove the top left cranial scalp, skull and left hemisphere , Revealed the falx and cerebellar tentacles, etc. ② left to remove the sagittal sinus The wall, exposed to the sagittal sinus cavity, in order to show the depth of the puncture: the sagittal parallel sagittal section of the anterior lateral to the lateral angle was “stepped” shallow shallow deep shallow membrane stripping, film and hatched aponeurosis membrane structure Each layer retains 3mm wide to show extracranial soft tissue levels with two 9-gauge needles, one from the anterior horn at the corner into the needle, the needle point to the eyebrow, and the scalp was 450 angle sting on the sagittal sinus , Piercing depth of about 4 ~ 5mm; the other in the posterior fontanel into the needle, the needle point to the front, with the scalp was 35 ° ~ 40 ° angle, piercing the superior sagittal sinus, piercing