正中神经返支和掌皮支血供的显微解剖

目的为修复正中神经返支提供带血管蒂神经桥接的有关数据和掌皮支血供的解剖学资料。方法用体视学方法研究了40侧灌注红色乳胶液的返支和掌皮支的营养血管。观察返支营养血管的来源、长度、外径和进入神经干的方式;观察掌皮支营养血管的来源和进入神经的方式。结果返支营养动脉主要发自掌浅弓凹侧筋膜支(称之来源动脉)。来源动脉起点至“零点”距离(11.62±2.30)mm,外径(0.95±0.10)mm,长度(10.12±1.30)mm。营养动脉主干长度(2.84±0.10)mm,外径(0.42±0.15)mm。营养动脉从返支主干近侧1/3段直入式进入神经者占86.5%;从返支中、远侧段伴入式进入神经者占14.5%;掌皮支营养动脉主要发自尺动脉(占52.5%)和桡动脉(占37.5%),以直式、伴入式和肌支式进入神经。结论返支营养动脉可作为血管蒂神经移植的受体血管。

Microanatomy of blood supply of recurrent branch of median nerve and palmar cutaneous branch

Objective To provide anatomical data concerning vessel pediceled nerve bridge connection and anatomical materials of palmar cutaneous vessel branch.Methods Forty cases of recurrent branch and palmar cutaneous branch trophic vessels filled with red emulsion were studied using the method of stereomicroscope.The source,length,external diameter of recurrcnt branch trophic vessels and its way of entering the trunk of nerve,and the source of palmar cutaneous branch trophic vessels and its way of entering nerve were observed.Results Recurrent branch trophic artery mainly came from the concaved side of the superficial palmar ach(called originate artery).The distance between starting point of originate artery and zero point was(11.62±2.30)mm.The length of trophic artery was(2.84±0.10)mm,external diameter(0.42±0.15)mm.86.5% of trophic artery entered nerve at the point of 1/3 of recurrent trunk,14.5% of which entered nerve from the side of palmar recurrent branch.Palmar cutaneous branch mainly originated from ulnar artery(52.5%)and radial artery(37.5%),entered nerve directly.Conclusion Original artery of recurrent branch tropic artery fits to receiving vessels of vessel pediccled nerve transplantation.