前臂外侧皮神经与头静脉营养血管远端蒂复合移植皮瓣的应用解剖(英文)  

Anatomic study of distally based compound flap pedicled with nutrient vessels of the lateral antebrachial cutaneous nerve-cephalic vein

作　　者：庄颜峰[1] 张发惠[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,福建省福州市350025

出　　处：《中国组织工程研究与临床康复》2007年第38期7693-7696,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：福建省自然科学基金资助项目(C0510034)~~

摘　　要：背景:前臂外侧皮神经营养血管皮瓣适合手部修复,但远端蒂血管缺少具体可操作性的描述,临床应用还比较困难。目的:探讨前臂外侧皮神经-头静脉营养血管远端蒂复合瓣和旋转点下移的解剖学基础。设计:单一样本观察。单位:解放军南京军区福州总医院军区临床解剖学研究中心。材料:实验于2004-01/05在解放军南京军区福州总医院军区临床解剖学研究中心实验室完成。选用30侧动脉灌注红色乳胶成人上肢标本(由解放军南京军区福州总医院军区临床解剖学研究中心提供)。方法:以桡骨茎突为观测标志点,重点显微解剖:①前臂外侧皮神经-头静脉下1/3段的营养血管来源、分支分布及吻合。②前臂外侧皮神经-头静脉营养血管与桡骨膜血管的关系。③头静脉浅深交通支。主要观察指标:①前臂外侧皮神经-头静脉营养血管的来源、分支及吻合。②前臂外侧皮神经-头静脉营养血管与邻近骨、皮的血供关系。结果:①在前臂的下1/3段,前臂外侧皮神经-头静脉的营养血管来源:该营养血管来自:桡动脉穿皮支6～11支,外径(0.7±0.3)mm;掌浅支穿皮支2～6支,外径(0.5±0.3)mm;桡骨茎突返支穿皮支一二支,外径(0.8±0.1)mm;鼻烟壶穿皮支一二支,外径(0.6±0.2)mm。在距桡骨茎突上8.0～15.0cm,桡动脉肌间隙骨皮穿支1～3支,起始外径(1.1±0.2)mm。骨膜支分布桡骨体部中下段的裸露区,皮支外径(0.8±0.2)mm。②在前臂的下1/3段,前臂外侧皮神经-头静脉的营养血管分布:前述穿皮支发皮支、筋膜支、皮神经-浅静脉营养血管,形成皮神经-头静脉血管链以及深、浅筋膜血管网。结论:前臂外侧皮神经-头静脉营养血管与肌、骨、皮营养血管同源,以桡动脉皮支为蒂前臂外侧皮神经-头静脉营养血管远端蒂复合瓣,旋转轴点在腕关节平面,可用于手部远处组织缺损修复。BACKGROUND： Flap pedicled with nutritional vessels of the lateral antebrachial cutaneous nerve is beneficial for repairing injury of dorsum; however, lacks of system researches of the lateral antebrachial cutaneous nerve compound flap. OBJECTIVE： To study the anatomic theory of the distally based compound flap pedicled with nutrient vessels of the lateral antebrachial cutaneous nerve - cephalic vein. DESIGN ： A single sample observation SETTING： Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese 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 Chinese PLA from January to May in 2004. A total of 30 upper limbs of adult cadavers perfused with red latex through arteries were provided by the Researching Center of Clinical Anatomy, Military Institute of Orthopaedics, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.METHODS ： The radial styloid process was taken as the mark for the microanatomical observation of the follows： （1） the origins, branches, distribution and anastomosis of nutrient vessels of the inferior 1/3 segment of lateral antebrachial cutaneous nerve-cephalic vein; （2） the relationship of nutrient vessels of lateral antebrachial cutaneous nerve-cephalic vein and radius periosteal vessels; （3） the superficial-deep communicating branches of cephalic vein. MAIN OUTCOME MEASURES ： （1） The origins, branches, distribution and anastomosis of nutrient vessels of the inferior 1/3 segment of lateral antebrachial cutaneous nerve-cephalic vein; （2） The relationship of nutrient vessels of lateral antebrachial cutaneous nerve-cephalic vein and radius periosteal vessels. RESULTS： （1） The origins of nutrient vessels supplying the inferior 1/3 segment of the lateral antebrachial cutaneous nerve were： 6 to 11 cutaneous branch

关 键 词：前臂外侧皮神经 营养血管 远端蒂 皮瓣 复合瓣 

分 类 号：R617[医药卫生—外科学]