Quantitative Measurement of Muscle and Subcutaneous Fat Thickness in Newborn by Real-Time Ultrasonography: A Useful Method for Site and Depth Evaluation in Vaccination

以實時間超音波方法測量新生兒肌肉及皮下脂肪厚度：有效評估預防注射最佳位置及深度的方法

羅韻珊(Yun-Shan Lo) ； 呂志忠(Chu-Chong Lu) ； 陳亮宇(Liang-Yeu Chen) ； 黃麗瑛(Li-Ying Huang) ； 鐘育志(Yuh-Jyh Jong)

《The Kaohsiung Journal of Medical Sciences》 8卷2期 (1992/02) Pp. 75-81

https://doi.org/10.6452/KJMS.199202.0075

摘要

本研究有50例足月新生兒(第一組)及30例平均壞孕週數為34.6 ± 1.7週，平均體重於2010.0 ± 257.7公克的低出生體重兒(第二組)接受超音波掃描測量肌肉及皮下脂肪厚度，以得到新生兒接受肌肉內注射時最理想的部位及深度；並評估該些部位肌肉厚度與體重、身長的相關性。
我們利用不具侵犯性的實時間超音波儀(Hitachi EUB40 及 5MHz掃描儀)測量兩組嬰兒大腿前外側，臀部外上方及臂肌中部的肌肉及皮下脂肪厚度。我們得到該些嬰兒肌肉的皮下脂肪厚度的正常分佈圖。兩組嬰兒的肌肉及皮下脂肪厚度均無性別上的差異。大腿肌肉及皮下脂肪厚度：第一組分別為11.8 ± 1.9 mm, 3.8 ± 0.4 mm。第二組為 8.6 ± 1.7 mm, 2.7 ± 0.5 mm。臀部肌肉及皮下脂肪厚度：第一組為 10.1 ± 1.5mm, 3.7 ± 0.5mm；第二組為 6.9 ± 1.2mm, 2.7 ± 0.7 mm。上臂肌肉及皮下脂肪厚度為：第一組 5.2 ± 0.7 mm, 3.4 ± 0.5 mm；第二組 3.8 ± 0.8 mm, 2.3 ± 0.6 mm。第一組嬰兒除了臀部肌肉與體重呈對數線性相關(r＝0.5)外，其他部位的肌肉厚度與體重、身長均不呈對數線性相關。第二組嬰兒的肌肉厚度與體重(在大腿、臀部及上臂肌肉r值分別為(0.6, 0.8, 0.6) 身長(r值分別為 0.4, 0.6, 0.6)均呈線性相關，統計上有意義(＜0.05)。兩組嬰兒的肌肉厚度均因體重及身長增加而增厚，特別在第二組肌肉增厚情形和體重間的相關最有意義。
在兩組嬰兒中，均以大腿前外側肌肉厚度最厚，較之其他部位有顯著差異(p＜0.05)。除此外，此處較不虞有造成主神經傷害的危性，因此為最適合嬰兒，特別是低出生體重兒注射之處。
利用超音波方法測量嬰兒各部位肌肉厚度是一簡單、實用的方法，適合臨床上應用。此研究結果為新生嬰兒肌肉厚度的基本資料，可作為肌肉增長及肌肉內注射深度的有用參考。

並列摘要

In order to quantify muscle thickness and choose the appropriate site for intramuscular injuction of vaccines in neonates, we used ultrasonography to measure muscle and subcutaneous fat thickness of anterolateral mid-thigh, upper outer quadrant of buttock and middle area of deltoid in fifty full term (group 1) and thirty low birth weight (group 2) infants. A Hitachi EUB40 real-time scanner and a 5 MHz transducer was used in the study.
We delineated the normal distribution of muscle and subcutaneous fat thickness in mid-thigh, buttock and deltoid areas of full term and low birth weight infants. There was no significant difference between male and female infants in the two groups. Muscle and subcutaneous fat thickness in the thigh area was 11.8 ± 1.9 mm and 3.8 ± 0.4 mm, respectively, in group 1; 8.6 ± 1.7 mm and 2.7 ± 0.5 mm in group 2. Figures in the buttock area were 10.1 ± 1.5mm and 3.7 ± 0.5mm in group 1, 6.9 ± 1.2mm and 2.7 ± 0.7 mm in group 2; and in the deltoid area were 5.2 ± 0.7 mm and 3.4 ± 1.5 mm in group 1 and 3.8 ± 0.8 mm and 2.3 ± 0.6 mm in group 2. There was significant logarithmic correlation between muscle thickness and body weight (r=0.6, 0.8, 0.6) and muscle thickness and body length (r=0.4, 0.6, 0.6) in thigh, buttock and deltoid areas of the low birth weight infants. In contrase, there was significant logarithmic correlation only between buttock muscle and body weight (r=0.5) in the full term infants.
We concluded that the ultrasonic method is a simple technique, easily performed in clinical use for muscle and subcutaneout fat thickness measurement. The mid-thigh muscle was found to be the thickest at the absence of risk to nerve injury. So, the mid-thigh is the preferred site and is recommended for intramuscular vaccination in the neonates. Intramuscular injection of vaccines should be performed with care, especially in low bith weight infants, because of thin muscle layers. The results of this study should be a useful guideline for assessment.

並列關鍵字

muscle thickness ； subcutaneous fat thickness ； ultrasonography