桡神经浅支的功能解剖学观察  

Anatomic Study of Different Way to Cutting Superficial Radial Nerve Transplanting to Repair Peripheral Nerve Defection and Functional Reconstruction of Donor Site

作　　者：李高峰[1] 田德虎[2] 董海涛 刁雪鸥[4] 于光辉[4] 梁立伟 

机构地区：[1]保定市第二医院骨科,河北保定071000 [2]河北医科大学第三医院手外科,河北石家庄050051 [3]河北省高阳县中医院骨科,河北高阳071000 [4]保定市第三医院,河北保定071000 [5]保定市恒星肿瘤医院骨科,河北保定071000

出　　处：《实用骨科杂志》2011年第6期530-533,545,I0001,共6页Journal of Practical Orthopaedics

摘　　要：目的对桡神经浅支进行功能解剖学观察,为桡神经浅支移植修复神经缺损提供解剖学依据。方法取成人前臂防腐标本30侧,测量下列数据:桡神经浅段长,桡神经浅支深段长,桡神经浅支不同部位的横径以及桡神经浅支分支处与前臂外侧皮神经、正中神经之间的垂直距离。用8侧新鲜肢体的前臂神经作冰冻切片,进行HE染色,在显微镜下计数其内各自的神经束数目;从头静脉注入聚氯乙烯环己酮溶液,观察头静脉的小属支与桡神经浅支的关系;经动脉灌注红色乳胶液,观察腕部正中神经的血供。结果桡神经浅支深段长度为(124.89+10.52)mm,浅段长度为(31.87+12.54)mm。桡神经浅支分支点与前臂外侧皮神经之间的垂直距离为(5.99+1.50)mm,与正中神经的垂直距离为(35.66+2.82)mm。结论桡神经浅支不仅可用于带血管或不带血管的游离移植,而且可用于前臂皮瓣术后的感觉重建,切取后远断端与正中神经或前臂外侧皮神经端侧吻合又能重建供区的功能,是临床上治疗神经缺损的良好供体神经。Objective In order to provide anatomic basis for clinic using of different way of cutting superficial radial nerve transplantation and reconstructing the function of the donor site. Methods We have investigated 30 adult cadaveric upper limbs （left 15 and right 15） that fixed by Formaldehyde. Then measured the data following：the length of the superficial radial nerve ,the length of deep the superficial radial nerve ,the vertical dimension from bifurcation of superficial radial nerve to lateral antebrachial cutaneous nerve and the vertical dimension to the median nerve. Eight fresh cadaveric upper limbs were selected to perform HE staining to count nerve-tract numbers of the same horizontal of cutaneous antehrachii lateralis nerve and median nerve under a microscope. 8 cephalic vein of fresh cadaveric upper limbs were perfused with polyvinyl chloride cyclohexanone solution,then the relation of little branches of cephalic vein and superficial radial nerve was observed. Red emulsion was perfused to arteries of 8 upper limb specimen,then the length and blood supply of median nerve were observed. Results The length of radial deep the superficial radial nerve is （124.89＋10. 52） ram,the length of the superficial radial nerve is （31.87＋12.54） mm,The vertical dimension from bifurcation of superficial radial nerve is to lateral antebrachial cutaneous nerve is （5.99＋ 1.50） ram. and the vertical dimension to the median nerve is （35.66＋2.82） ram. Conclusion The superficial radial nerve not only using free grafting with blood vessel or not with blood vessel,but also using to rebuild aesthema of operating antebrachial flap. After cutting superficial radial nerve ,we can reconstruct sensory function of the donor by way of end-to-side anasto-mosis between far broken ends of superficial radial nerve and median nerve or and lateral antebrachial cutaneous nerve. The superficial radial nerve is a better donator nerve for curing neurologic defect.

关 键 词：桡神经浅支 解剖 端侧吻合 功能重建 

分 类 号：R323[医药卫生—人体解剖和组织胚胎学]