冈上肌腱的血供特点及临床意义  

Blood supply of the supraspinatus and its clinical significance

作　　者：许本柯[1] 杨运平[2] 刘洪涛[1] 罗钢[1] 刘兵[1] 刘本菊[1] 

机构地区：[1]长江大学医学院,湖北荆州434000 [2]南方医科大学南方医院创伤骨科,广州510515

出　　处：《中国临床解剖学杂志》2012年第1期33-35,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的为肩关节疾患的防治及肩关节功能的重建提供血供解剖学基础。方法采用40侧常规防腐灌注红色乳胶的成人上肢标本,解剖出冈上肌观察其形态结构、起止点、血供来源、走行、分布特点并测量有关数据。结果冈上肌的血供主要来自肩胛上动脉和颈横动脉降支。肩胛上动脉起始处外径为(2.9±0.3)mm,主干长(4.8±0.7)cm;营养冈上肌肌支在肩胛横韧带的上方或下方分为2～3支进入肌腹。其入肌点位于肩胛横韧带的前下方(1.9±0.2)mm;冈上肌腱在移行部和扩展部动脉吻合丰富,而在实质部距肌腱止点部1 cm处毛细血管稀疏,是一个明显的乏血管区。冈上肌的神经支配主要是肩胛上神经,与血管伴行分2～3支支配冈上肌。结论肩袖撕裂或肩袖损伤考虑行手术修复时,不宜采取简单的断端缝合,应将断端的缺血组织切除后再行缝合或采用合适的肌腱代用材料进行修补,改善局部血供,有利于愈合。Objective To provide anatomic basis of blood supply for preventing and treating of shoulder joint disease and reconstructing of shoulder joint function.Methods 40 specimens of adult upper limbs fixed and perfused with red emulsion were used.Supraspinatus was dissected for exploring its anatomic features.Results The blood supply of supraspinatus was mainly from the suprascapular artery and the descending branch of transverse cervical artery.The outer diameter at the beginning was（2.9±0.3） mm,and the length of main trunk was（4.8±0.7） cm.The muscular branches supplying supraspinatus divided into two to three branches to enter the muscle belly above or below the scapula ligamentum transversum.The place of the branches entering the muscle belly located at the point（1.9±0.2） mm antero-inferior to the scapula ligamentum transversum.The arterial anastomosis of tendon of supraspinatus was affluent at the transmigration part and expansion part.While the capillary was rare at the place 1 cm distal to the insertion of tendon in the parenchyma part,which was a apparent area lacking of blood vessels.The supraspinatus was mainly innervated by suprascapular nerve,which divided into two to three branches accompanied by blood vessels to innervate supraspinatus.Conclusions On repairing of the rotator cuff tear or injury,it is unsuitable to simply sew the broken end.The broken end sew should be performed after cutting the ischemic tissue or transferring suitable tendon medium,for improving the regional blood supply,which is helpful for healing.

关 键 词：冈上肌 肌腱 肩袖 

分 类 号：R323.24[医药卫生—人体解剖和组织胚胎学]