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作 者:唐举玉[1] 李康华[1] 吴梅英[2] 罗令[1] 宋达疆[1]
机构地区:[1]中南大学湘雅医院骨科,长沙410008 [2]中南大学湘雅医院超微结构研究室
出 处:《中华显微外科杂志》2009年第1期47-50,F0003,共5页Chinese Journal of Microsurgery
基 金:湖南省卫生厅科研基金资助项目(2005043)
摘 要:目的为临床开展股前外侧皮瓣移植修复足跟软组织缺损感觉重建提供指导。方法选择7具成年男性标本,分别于股外侧皮神经髂前上棘下5cm、跟内侧神经和跟外侧神经第一支主干起始段切取神经样本。经固定、梯度脱水、包埋、修块定位和半薄切片后,以甲苯胺蓝染色。以MOTICMED6.0数码医学图像分析系统摄取图片,观察神经截面形态、神经纤维束组数目和排列,计数神经纤维和测定神经纤维密度。采用photoshop7.0选区面积计算软件测量和计算神经纤维束组面积;应用photoshop网格功能测量和计算神经纤维密度。结果股外侧皮神经、跟内侧神经和跟外侧神经第一支的平均神经束组数分别为4束、3束和4束,束组面积分别为114.28μm^2、126.92μm^2、102.76μm^2,纤维密度分别为11.43束/μm^2、6.47束/μm^2、10.08束/μm^2,神经纤维束分别为987束、862束、570束。结论跟内侧神经和跟外侧神经第一支具有与股外侧皮神经较为相似的截面形态特点,股前外侧皮瓣移植修复足跟大面积软组织缺损时,适宜选择跟内侧神经或跟外侧神经第一支与股外侧皮神经吻合来重建皮瓣感觉。Objective To provide guidance for reconstructing the sensation of the anterolateral thigh flap(ALTF) used to repair extensive soft tissue defects in heel. Methods Choose 7 adult male corpses, take the nerval samples respectively from the lateral femoral cutaneous nerve (LFCN) 5cm below the anterior superior iliae spine (ASIS) and the initial segment of the medial calcaneal nerve (MCN) and the lateral calcaneal nerve (LCN), fixed, dewatered gradiently, embedded, located, and made them into semithin sections, dyed with toluidine blue. The pictures were taken by a medicine figure imaging analysis system named MOTICMED 6.0, observe the nerves' s sectional morphous, the quantity and distribution of their nerve fiber bundles, count the quantity of nerve fibers and determine the density of them. Use Photoshop 7.0 version precinct software for measuring and calculating the area of the nerve fiber bundles and the Photoshop grid function was used to measure the density of the nerve fibers. Results In our cross-section study, the median number of nerve bunches in LFCN, MCN and LCN1, was 4, 3 and 4, respectively. The median number of nerve fibers' area was 114.8 μm^2, 126.92 μm^2 and 102.76 μm^2, respectively. The median number of nerve fibers' density was 11.43/μm^2, 6.47/μm^2 and 10.08/μm^2, respectively. The median number of nerve fibers was 987, 862 and 570, respectively. Conclusion The MCN and the LCN1 are ideal cutaneous nerves to suture with LFCN in the ALTF used to repair widespread soft tissue defects in heel because they have similar histomorphologieal characteristics with the LFCN.
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