小腿前群肌神经入肌点定位及在阻滞肌痉挛中的意义  

Localization of the nerve entry points of the anterior leg muscles and its significance in blocking muscle spasticity

作　　者：胡向楠 胡帅宇 杨胜波 Hu Xiangnan;Hu Shuaiyu;Yang Shengbo(Department of Anatomy,Zutiyi Medical University,Zunyi 563099,Guizhou Province,China)

机构地区：[1]遵义医科大学人体解剖学教研室,贵州遵义563099

出　　处：《中国临床解剖学杂志》2021年第3期247-251,共5页Chinese Journal of Clinical Anatomy

基　　金：国家自然科学基金(31660294,31540031)。

摘　　要：目的准确地定位小腿前群肌神经入肌点(NEP)的体表位置和深度。方法20具中国成年人尸体。设计紧贴皮肤连接股骨外上髁与腓骨外踝的曲线为纵向参考线(L),连接股骨外上髁与内上髁的曲线为横向参考线(H)。解剖暴露NEP,硫酸钡标记,螺旋CT扫描,三维重建,Syngo系统下确定NEP在体表前后的投影点(P和P’点),P点投射到L和H线上的位置(PL和PH点)及NEP的深度。结果胫骨前肌、长伸肌、趾长伸肌均有一个较为恒定的NEP,其中PL点分别位于L线的(23.63±2.43)%、(52.46±2.94)%和(36.07±2.99)%处;PH点分别位于体表H线上的(27.27±2.58)%、(34.41±2.38)%和(32.11±2.52)%处;深度分别位于PP’线的(45.32±3.06)%、(36.20±2.84)%和(33.72±3.18)%处。结论这些NEP的体表位置和深度的界定将为提高小腿前群肌痉挛肌外神经溶解术靶点定位的效率与疗效提供形态学指导。Objective To accurately localize the body surface location and depth of nerve entry points(NEPs)of the anterior leg muscles.Methods Twenty chinese adult cadavers were used.The curved line close to skin connecting the lateral femoral epicondyle and the lateral malleolus of fibula was designed as the longitudinal reference line(L line).A curved line connecting the lateral femoral epicondyle and medial femoral epicondyle was designed as the horizontal reference line(H line).Following dissection,the NEPs were labeled with barium sulfate and then subjected to spiral computed tomography scanning and threedimensional reconstruction.Syngo system was used to identify the projection points(points P and P’)of the NEPs on anterior and posterior skin surface of the leg,the location(points PL and PH)of point P projected on the L and H lines and the depth of NEPs.Results There was a constant NEP in tibialis anterior,extensor hallucis longus and extensor digitorum longus muscles,and the points PL were located at(23.63±2.43)%,(52.46±2.94)%and(36.07±2.99)%of the L line,respectively;the points PH were at(27.27±2.58)%,(34.41±2.38)%and(32.11±2.52)%of the H line,respectively;the depth of NEPs were at(45.32±3.06)%,(36.20±2.84)%and(33.72±3.18)%of the PP’line,respectively.Conclusions The identification of the surface position and depth of these NEPs will provide morphological guidance for improving the localizing efficiency of extramuscular neurolysis and the efficacy during anterior leg muscle spasticity.

关 键 词：小腿前群肌 肌痉挛 神经入肌点 螺旋CT 定位 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]