贵要静脉营养血管远端蒂复合瓣的解剖学特征(英文)  

Anatomical characteristics of distally based compound flap pedicled with nutrient vessels of the basilic vein

作　　者：张发惠[1] 张志宏[1] 郑和平[1] 张国栋[1] 

机构地区：[1]解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心,福建省福州市350025

出　　处：《中国临床康复》2006年第44期226-228,F0003,共4页Chinese Journal of Clinical Rehabilitation

基　　金：福建省自然科学基金资助项目(C0510034)~~

摘　　要：背景:前臂皮神经营养血管皮瓣特别适宜手部远端的组织缺损修复,所以了解贵要静脉远端的营养血管及与邻近骨、皮和前臂内侧皮神经的血供关系对临床上前臂皮神经营养血管远端蒂复合瓣的设计有重要意义。目的:研究前臂尺侧缘远端的动脉穿支,为前臂尺侧缘贵要静脉营养血管远端蒂复合瓣的设计提出解剖学理论。设计:单一样本实验。单位:解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心。材料:实验于2004-05/10在解放军南京军区福州总医院军区骨科研究所临床解剖学研究中心实验室完成。研究材料为30侧动脉灌注红色乳胶成人上肢标本(由南京军区福州总医院军区骨科研究所临床解剖学研究中心提供)。方法:将30侧成人上肢标本,以尺骨茎突为观测标志点进行显微解剖。主要观察指标:重点观察:①前臂尺侧缘远端的动脉穿支来源。②动脉穿支与贵要静脉远端的营养血管。③营养血管与邻近骨、皮和前臂内侧皮神经的血供关系。④贵要静脉的浅深交通支。结果:①前臂尺侧缘远端的动脉穿支来自:尺动脉的皮支5～9支,外径(0.7±0.3)mm,尺动脉腕上皮支1～3支,外径(0.6±0.3)mm。在尺骨茎突上方6.0～16.0cm,骨间前动脉发骨皮穿支二三支,骨间后动脉发骨皮穿支1～3支,二者外径在0.4～1.2mm,分布尺骨中下段骨膜及相应区域的皮肤。②上述动脉穿支均发皮支、筋膜支、骨膜支、贵要静脉和皮神经营养血管支,形成贵要静脉旁血管链和皮神经干血管链以及深、浅筋膜和骨膜血管网。结论:前臂尺侧缘远端的动脉穿支是贵要静脉营养血管的来源,营养血管与邻近的骨、皮和前臂内侧皮神经的营养血管同源,是设计贵要静脉营养血管远端蒂复合瓣的解剖学基础。以尺动脉腕上皮支为蒂的远端蒂复合瓣,旋转轴点可达腕关节平面,用于转位修复手部远处的组BACKGROUND： Skin flap of nutrient vessel of antebrachial cutaneous nerve is benefieial for repairing injury of distal tissue of hand; thus, it is important for comprehending the correlation of blood supply between distal nutrient vessel of basilic vein and medial cutaneous nerve of bone, skin and forearm to design distal pedieled flap of nutrient vessel of antebraehial cutaneous nerve on elinie. OBJECTIVE： To investigate distally arterial perforating branch of ulnar margin of forearm and provide anatomical bases for designing distal pedicled flap of nutrient vessel in basilic vein of ulnar margin of forearm, DESIGN： Simple sample study. SETTING： Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of PLA. MATERIALS： The experiment was carried out at the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of PLA from May to October 2004. Thirty upper limbs of adult cadavers perfused with red latex through arteries were provided by Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of PLA. METHODS： Samples of lateral upper limbs of 30 adults were dissected as the pivot point of styloid process of ulna with microscope. MAIN OUTCOME MEASURES： （1） Sources of distally arterial perforating branch of ulnar margin of forearm; （2） nutrient vessel between perforating branch and basilic vein; （3） correlation of blood supply between nutrient vessel and medial cutaneous nerve of bone, skin and forearm; （4） superticial and deep communicating branch of basilic vein. RESULTS： （1） Sources of distally arterial perforating branch of ulnar margin of forearm, which was derived from 5-9 cutaneous branches ulnar artery with external diameter of （0.7±0.3） mm, 1-3 upper cutaneous branches ulnar artery with the external diameter of （0.6±0.3） mm, 6.0

关 键 词：贵要静脉 肌皮神经 外科皮瓣 前臂 

分 类 号：R324[医药卫生—人体解剖和组织胚胎学]