游离背阔肌皮瓣的感觉神经支配应用解剖  

Applied anatomy of free latissimus dorsal muscular flap with sensate nerve

作　　者：颜玲[1] 钟世镇[1] 徐达传[1] 高建华[2] 邵正仁[3] 

机构地区：[1]第一军医大学临床解剖学研究所,广州510515 [2]第一军医大学南方医院整形科,广州510515 [3]蚌埠医学院解剖学教研室,安徽蚌埠233003

出　　处：《中国临床解剖学杂志》2001年第1期11-13,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的 :为形成带感觉神经的游离背阔肌皮瓣提供解剖学基础。方法 :在 2 0例 40侧成人躯干标本上 ,观测了分布于背阔肌区域的肋间神经、胸脊神经的来源、走行及分布规律。结果 :T5～ 10 神经外侧支的后支在腋前线 1～ 2cm相应肋间穿出 ,呈节段性重叠性分布肩胛线以外的背阔肌区皮肤 ;其中T6～ 8分布于皮瓣范围较大、神经蒂较长并距血管蒂较近。第 6～ 11胸脊神经后支穿出骶棘肌后 ,在胸腰筋膜中走行4～ 5cm距离 ,后穿出在背阔肌浅层走行 3～ 5cm ,呈重叠性节段性分布于肩胛线内侧的背阔肌区的皮肤。其中以第 8、9胸脊神经后支在皮瓣中分布较大。结论 :可设计以第 6～ 8肋间神经外侧支的后支和 /或以第 8、9胸脊神经后支为神经蒂的感觉背阔肌皮瓣。Objective: To provide anatomical basis for the free latissimus dorsal muscular flap with sensate nerve. Methods: The origin,branch and distribution of the thoracic nerve within the area of latissimus dorsal muscular were observed on 20 adult specimens. Recults: The lateral posterior branch of 5～10 thoracic nerve piece through their respective intercostal tissus near anterior axial line, and distribute in the skin of latissimus dorsal muscular area. Particularly, T 6～8 have a bigger nerve distribute area and a longer nervre pedicle which near the artery pedicle. The posterior branch of 6～11 thoracic nerve run in the deep fascia for 4～5 cm, then appear in the fascia of latissimus dorsal muscular about 3～5 cm.The distribute area of 8 and 9 thoracic nerve are especially greatre others. Conclusions: It is possible to design a sensate latissimus dorsal muscular flap with the 6～8 lateral posterior branch and/or the 8～9 lateral posterior branch of thoracic nerve.

关 键 词：背阔肌感觉皮瓣 肋间神经 外和皮瓣 感觉神经 应用解剖 

分 类 号：R622.1[医药卫生—整形外科] R322.85[医药卫生—外科学]