皮神经营养血管皮瓣的临床解剖学研究  

Clinical anatomy study on neurocutaneous vascular flap

作　　者：何波[1] 傅国[1] 郑灿镔[1] 朱庆棠[1] 丁自海[2] 顾立强[1] 王增涛[3] 刘小林[1] 

机构地区：[1]中山大学附属第一医院显微创伤骨科,广州510090 [2]南方医科大学人体解剖学教研室 [3]山东大学山东省立医院手足外科

出　　处：《中华显微外科杂志》2012年第5期395-398,I0008,共5页Chinese Journal of Microsurgery

摘　　要：目的研究皮神经营养血管皮瓣的血供特点，为临床皮瓣切取提供解剖学基础。方法灌注10具20侧新鲜人体标本，对前臂外侧皮神经、前臂内侧皮神经、腓肠神经、腓浅神经、隐神经及其营养血管进行了临床解剖学研究，对其营养穿支动脉来源、分布进行观察。结果皮神经营养血管或为一口径较大的营养动脉，伴皮神经随行较长距离；或为由神经表面多个上、下位节段性血管的升支与降支之间形成纵向血管链。前臂内侧、外侧皮神经、腓肠神经、腓浅神经、隐神经分别有尺动脉腕上穿支、桡动脉腕上穿支、外踝上前穿支、外踝上后穿支、内踝上穿支营养，出现率分别为100％、95％、80％、90％和100％。结论起自深部主干动脉的血管皮穿支是构成神经营养血管的解剖学基础．它的分布同样遵循“压力平衡”规律。大多皮神经有恒定穿支参加皮神经营养，皮神经营养血管实质上是一种可以预见并易于临床寻找的链式血管。Objective To provide vascular feature of neurocutaneous vascular flap and anatomical de- tails about how to design the flap. Methods Ten fresh human body sample with twenty limb were perfused. The clinical anatomy of lateral antebrachial cutaneous nerve, medial antebrachial cutaneous nerve, sural nerve, superficial peroneal nerve, saphenous nerve and their nutrient vessels were studied. The distribution of their nu- trient perforators were observed. Results Neurocutaneous nutrient vessels or nutrition artery with large diam- eter were accompanying nervus eutaneus by a long distance; Or longitudinal vascular chains were formed by ra- mus communieans with the ascending branches and descending branches from multiple segmental vessels. Medi- al antebrachial cutaneous nerve, lateral antebrachial cutaneous nerve, sural nerve, superficial peroneal nerve, saphenous nerve has the ulnar artery perforating branches, radial artery perforating branches, anteriolateral supra malleolar perforating branches, posterolateral supra malleolar perforating branches, medial supra malleo- lar perforating branches, accompanied separately, and the occurrence rate were 100%, 95%, 80%, 90%, 100% respectively. Conclusion Cutaneous branch from the main deep artery is the anatomical basis of neuro- cutaneous nutrient vessel. Its distribution also accord to ＂pressure balance＂ rule. Mostly nervus cutaneus had constant perforator attending to suply its nutrition. Actually neurocutaneous nutrient vessel is a predictable and reliable vascular chain.

关 键 词：皮神经营养血管皮瓣 穿支皮瓣 临床解剖 

分 类 号：R322.99[医药卫生—人体解剖和组织胚胎学]