闭孔神经或生殖股神经移位修复腰骶丛根性撕脱伤的应用解剖学研究  

Applied anatomy of the nerve transfer to repair lumbosacral plexus nerve avulsion injuries

作　　者：尹刚[1] 侯春林[1] 盛军[1] 林浩东[1] 

机构地区：[1]第二军医大学附属长征医院骨科,上海200003

出　　处：《中国临床解剖学杂志》2012年第5期487-490,共4页Chinese Journal of Clinical Anatomy

基　　金：上海市科学技术委员会科研计划项目(10411954000)

摘　　要：目的为闭孔神经或生殖股神经移位修复腰骶丛根性撕脱伤的临床应用提供解剖学基础。方法新鲜成人整尸6具，解剖测量双侧闭孔神经、生殖股神经、股神经及骶神经根的长度、横径和纵径，计算横截面积，并在高倍显微镜下计数有髓神经纤维数目。结果右侧闭孔神经经椎体前腹膜后移位至左侧，与左侧股神经均能直接吻合，且有2～3cm的重叠。左侧生殖股神经、闭孔神经切断后均能与同侧S1、S2神经根吻合，且有2-4cm的重叠。闭孔神经的神经纤维数目（4400～7800根）为股神经纤维数目（13000-20000根）的1／3，生殖股神经的神经纤维数目（3000-4500根）为骶2神经的纤维数目（4500～8500根）的1／2，闭孔神经纤维数目（4400-7800根）与S1神经纤维数目（5000～9000根）基本相当。结论闭孔神经或生殖股神经可作为动力源神经移位修复腰骶丛根性撕脱伤。Objective To provide anatomic basis for clinical application of the obturator nerve and/or genitofemoral nerve tmnsfering to repair the lumbosacral plexus nerves avulsion injuries. Methods The length, cross diameter, longitudinal diameter, cross-sectional area and the amount of myelinated nerve fibers of obturator nerve, genitofemoral nerve, femoral nerve, lumbosacral plexus and sacral plexus on both sides of 6 adult cadaveric specimens were exposed and measured respectively. Results The right proximal obturator nerve could be transfered to the left distal femoral nerve through anterior surface of vertebrae and posterior surface of the peritoneum, with the overlap of fiber terminals about 2-3 cm. The right obturator nerve and genitofemoral nerve could be transfered to ipsilateral $1 and $2 nerve root with the overlap of 2-4 cm respectively. The fiber number of the obturator nerve （4400-7800） was about 1/3 of the femoral nerve （13000-20000）. The fiber number of genitofemoral nerve （3000-4500） was about 1/2 of the S2 nerve （4500-8500）. The fiber number of obtumtor nerve （4400-7800） was roughly equal to that of the Sl nerve （5000-9000）. Conclusions Obturator nerve and genitofemoral nerve can be used as donor nerves to repair the lumbosacral plexus nerve avulsion injuries.

关 键 词：闭孔神经 生殖股神经 腰骶丛神经 神经移位 撕脱伤 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学]