隐神经营养血管远端蒂皮瓣的应用解剖  

Applied anatomy of saphenous nerve nutritional vessels flap pedicled distally

作　　者：张发惠[1] 郑和平[1] 谢其扬[2] 林松庆[1] 

机构地区：[1]南京军区福州总医院军区临床解剖学研究中心,福州350025 [2]福建医科大学附属第一医院骨科

出　　处：《解剖学杂志》2005年第2期209-211,i006,共4页Chinese Journal of Anatomy

摘　　要：目的:为隐神经营养血管皮瓣设计提供解剖学依据。方法:灌注红色乳胶成人下肢标本30侧,解剖观测大隐静脉隐神经营养血管及其吻合关系。结果:小腿内侧下1/3段有胫后动脉肌间隙支2～3支,外径(1.1±0.3)mm;骨皮穿支1～2支,外径(1.0±0.3)mm;内踝前动脉踝前内侧穿支外径(0.6～0.8)mm;胫前动脉踝上穿支外径(0.8±0.3)mm。上述穿支吻合构成前、中、后3条纵向的血管丛以及骨膜、深筋膜和神经浅静脉3个层面的血管丛。结论:小腿内侧下1/3段有明显的多源性供血,皮肤、筋膜、骨膜、大隐静脉和隐神经等的营养血管同源,可以设计以胫后动脉肌间隙支为蒂的小腿内侧隐神经营养血管远端蒂皮瓣。Objective: To provide anatomic basis for the saphenous nerve nutritional vessels flap pedicled with the intermuscular septum branches of posterior tibial artery.Methods:The nutritional vessels of great saphenous vein, saphenous nerve and anastomosis of arteries were observed on 30 adult cadaveric low limb specimens,which was perfused with red gelatin.Results:The intermuscular septum branches of posterior tibial artery had 2-3 branches with the average diameter being (1.1±0.3) mm. The perforating branches of bone cutaneous had 1-2 branches with the diameters being (1.0±0.3) mm. The diameters of perforating branches of medial anterior malleolar were (0.6-0.8)mm, and that of superior malleolus were (0.8±0.3) mm. Above-mentioned perforating branches had a plentiful of anastomosis.The nutrient vessels formed the anterior,the center and the posterior strips for anastormosis of vascular plexus and the periosteal,deep fascia,nerve and superficial vein vascular plexus.Conclusion:The results suggest that there are multi-sources of blood supply to the 1/3 segment at the medial of the leg. The nutrient vessels of skin,fascia,periosteum, great saphenous vein and saphenous nerve derived from the same source. The saphenous nerve nutritional vessels flap pedicled with intermuscular brandles of posterior tibial artery can be designed.

关 键 词：远端蒂皮瓣 应用解剖 隐神经营养血管皮瓣 小腿内侧 大隐静脉 肌间隙支 胫后动脉 解剖学依据 内踝前动脉 解剖观测 胫前动脉 血管丛 外径 皮穿支 浅静脉 深筋膜 多源性 吻合 骨膜 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]