儿童小腿后群肌肌内神经分布模式  

Distribution pattern of intramuscular nerves in the posterior group of children’s calves

作　　者：王文康 燕燕 温建立 谢鹏 WANG Wenkang;YAN Yan;WEN Jianli;XIE Peng(Department of Critical Care Medicine,the Third Affiliated Hospital,Zunyi Medical University(the First People′s Hospital of Zunyi),Zunyi,Guizhou 563000;Department of Anatomy,Zunyi Medical University,Zunyi,Guizhou 563000)

机构地区：[1]遵义医科大学第三附属医院(遵义市第一人民医院)重症医学科,贵州遵义563000 [2]遵义医科大学人体解剖教研室,贵州遵义563000

出　　处：《郑州大学学报（医学版）》2019年第5期676-680,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金项目(31360256,31660290)

摘　　要：目的:探索儿童小腿后群肌肌内神经分布模式,为脑瘫患儿小腿后群肌A型肉毒毒素(BTX-A)抗痉挛治疗的注射靶区提供精确定位。方法:采用改良的Sihler′s肌内神经染色技术观察26具(52侧)童尸小腿后群肌(比目鱼肌、腓肠肌、踇长屈肌、趾长屈肌及胫骨后肌)的肌内神经分布模式,并确定终末神经密集区的位置。结果与结论:比目鱼肌肌内神经分支走形整体呈扫帚状,终末神经密集区主要位于肌腹下1/2。腓肠肌内、外侧头的肌内终末神经密集区均位于肌腹下1/3。踇长屈肌终末神经密集区类似长方形,主要位于肌腹中下部。趾长屈肌肌内终末神经密集区呈条带状,主要位于肌腹中部。胫骨后肌肌内终末神经密集区主要位于肌腹中部。BTX-A抗痉挛治疗的最佳注射靶区为上述各肌相应的肌内终末神经密集区。Aim:To investigate the intramuscular nerve distribution pattern in the posterior calf muscles of children,and locate the BTX-A injection site for posterior calf muscles spasticity resistance of children with cerebral palsy.Method:Sihler′s whole mount nerve staining technique was employed to observe the distribution of intramuscular nerves in posterior calf muscles(soleus,gastrocnemius,Flexor halluccis longus,Flexor digitorum longus and Tibialis posterior)of 26 children corpses,and the terminal nerves concentrated areas were located.Results and Conclusion:The intramuscular nerve branches of soleus muscle are shaped like a broomstick,and the concentrated area of terminal nerve is mainly located in the lower half of the muscle abdomen.The intramuscular terminal nerve concentration areas of the medial head of gastrocnemius and the lateral head of gastrocnemius are located in the lower 1/3 of the muscle abdomen.The terminal nerve area of Flexor halluccis longus are similar to rectangles that lie mainly in the lower part of the muscular abdomen.The intramuscular terminal nerve density area of Flexor digitorum longus is in the shape of band,which is mainly located in the middle part of muscle abdomen.The intramuscular terminal nerves of the Tibialis posterior are concentrated mainly in the middle of the muscle abdomen.The best targets for BTX-A injection are the dense regions of terminal nerves described above.

关 键 词：脑瘫 小腿后群肌 肌内神经分布 

分 类 号：R322.7[医药卫生—人体解剖和组织胚胎学]