正中神经手内肌功能束(组)的神经纤维定量研究  

Histological study of the fascicular group to the hand intrinsic muscles of the median nerve

作　　者：邵岩[1] 顾立强[1] 李绍光[1] 张景廖[1] 谢颍涛[1] 

机构地区：[1]南方医科大学南方医院创伤骨科,广州510515

出　　处：《中华手外科杂志》2005年第3期186-188,共3页Chinese Journal of Hand Surgery

基　　金：广东省科技计划攻关项目(2002c31003)

摘　　要：目的提供正中神经手内肌功能束组(支)的组织学特征,为临床修复手内肌功能的手术设计和估计预后提供组织学依据。方法应用Loyez髓鞘染色法显示断面有髓神经纤维,通过显微图像分析系统(德国产Leica),测算神经分支及各断面的神经纤维数目和结缔组织面积等指标。结果(1)鱼际肌支有髓神经纤维数为[(1475±143)根;x±s,下同]。(2)有髓神经纤维密度(有髓神经纤维数/鱼际肌支截面积)为(1130.76±77.09)根/mm2。结论臂丛神经损伤修复正中神经手内在肌支,从理论上讲,以选择在前臂远端直接修复为宜。因在近端修复需要数量庞大的供体运动神经纤维,移位的神经纤维数可能远远不够。Objective The attempt to perform nerve transfer to recover function of intrinsic muscles of the hand demands detailed knowledge about the fascicular group in the median nerve per se that innervates the intrinsic muscles of hand in the nerve trunk. Methods Loyez myelin sheath staining of cross sections of cadaver median nerves was conducted. Histomorphological features of the fascicular groups to the intrinsic muscles of the hand were observed. Myelinated fiber count and nerve fiber density were recorded. Results The total number of myelinated nerve fibers of the thenar muscle branch was 1 475±143. The nerve fiber density (myelinated nerve fiber count/cross-sectional area) of the thenar muscle branch was 1 130.76±77.09/mm 2. Conclusion To restore function of the hand intrinsic muscles in brachial plexus injuries, it is more faverable to reconstruct the median nerve at the forearm level. Any functioning donor nerve in the reasonable proximity can be considered.

关 键 词：正中神经 定量研究 有髓神经纤维 图像分析系统 鱼际肌支 组织学特征 手内肌功能 髓鞘染色法 功能束组 手术设计 临床修复 方法应用 结缔组织 神经分支 纤维密度 损伤修复 臂丛神经 直接修复 维数 截面积 断面 

分 类 号：R658[医药卫生—外科学]