前臂骨骼肌亚部化及肌构筑研究  

EXPERIMENTAL RESEARCH OF NEUROMUSCULAR COMPARTMENTS AND MUSCULAR ARCHITECTURE OF FOREARM SKELETAL MUSCLES

作　　者：刘本立[1,2] 刘安堂[1] 江华[1] 陈刚[1] 于大志[1] 党瑞山[3] 

机构地区：[1]第二军医大学附属长征医院整形外科,上海200003 [2]济南军区总医院烧伤整形科 [3]第二军医大学解剖学教研室

出　　处：《中国修复重建外科杂志》2009年第3期332-336,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：上海市科学技术发展基金(024119057);上海市基础研究重点课题(08JC1407100)~~

摘　　要：目的研究前臂骨骼肌亚部的形态学特征及肌构筑特点,探讨肌亚部化移植的可行性,为临床肌亚部移植手术提供形态学依据。方法第二军医大学解剖学教研室提供的冰冻上肢标本10例20侧,均为男性,年龄26～39岁。用改良Sihler染色法对10侧桡侧腕屈肌、尺侧腕屈肌、桡侧腕短伸肌、尺侧腕伸肌、掌长肌、拇长屈肌及旋前圆肌进行肌内神经染色,以观察肌内神经的分支分布。另取10侧标本,前臂上述肌肉沿肌腱长轴分为尺侧半和桡侧半,根据Wickiewicz肌构筑研究方法测量其构筑学特征。结果各肌肉神经在入肌前或入肌后发出2支或以上神经分支,分别进入尺侧半和桡侧半。各分支以肌内腱板为界,两侧的肌内神经各支配一侧肌肉。各肌肉所分成的两亚部之间,生理横切面积相比差异均有统计学意义(P<0.05);其中以尺侧腕屈肌尺侧半最大,掌长肌两亚部及旋前圆肌尺侧半较小。各肌肉两亚部之间生理横切面积与肌湿重比值,差异均无统计学意义(P>0.05)。生理横切面积与肌纤维长度比值,旋前圆肌尺侧半、掌长肌两亚部较高,尺侧腕屈肌尺侧半最小,与其余各亚部比较差异有统计学意义(P<0.05);其余各亚部间差异无统计学意义(P>0.05)。结论前臂各肌可分为尺侧半和桡侧半两亚部;各亚部的生理功能特征存在差异;对选择和切取理想的部分肌肉移植,重建运动功能提供了理论依据。Objective To reveal morphologic features and physiological function in compartments of human forearm muscles,and investigate the possibility of transplantation of neuromuscular compartments. Methods Sihler’s neural staining technique was used to study the nerve branches distribution of forearm skeletal muscles in 5 human cadavers （aging 26-39 years）,including exor carpi radialis,exor carpi ulnaris （FCU）,extensor carpi radialis brevis,extensor carpi ulnaris,palmaris longus （PL）,flexor pollicis longus,pronator teres （PT）. According to Wickiewicz’s methods,Ulnar compartment and radial compartment of forearm skeletal muscles above mentioned from 10 human cadvers were used to study the muscle architectural features. Results Each nerve branches run into the ulnar compartment and radial compartment respectively. There was statistically signi cant di erence between the two physiological cross section areas （PSCA） of each neuromuscular compartment from forearm muscles（P 〈 0.05）. Among them,PSCA of ulnar compartment of FCU was the largest. The PSCA of ulnar compartment of PT was the smallest. There was no statistically di erence between the ratio （PSCA/muscle wet weight） of each neuromuscular compartment from forearm muscles （P 〉 0.05）. As the ratio of PSCA to the muscle ber length,the ulnar compartment of PT and the two compartments of PL had the highest one while the ulnar compartment of FCU had the smallest; and there was no statistically di erence among the other neuromuscular compartments （P 〉 0.05）. Conclusion Each of forearm muscles be divided into ulnar compartment and radial compartment and they have their own nerve supply. And there are signi cant di erences in the physiological function in compartments of forearm muscles,which can be references in muscular compartment transplantation.

关 键 词：前臂 肌肉移植 肌内神经 骨骼肌亚部 肌构筑 解剖 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]