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1.
在30侧成人尸体标本上,解剖观察了冈上肌及其浅面斜方肌的形态,血供和神经分布。冈上肌肌腹长10.0±2.8cm,中部宽3.8±0.8cm,中部厚1.7±0.4cm,肌腱长3.5±0.4cm,宽3.1±0.3cm;覆盖在冈上肌浅面的斜方肌,肩峰处水平长15.5±2.7cm,中部厚1.6±0.3cm,在距止点1.5±0.5cm处为腱性结构,并与肩峰骨膜相延续。根据解剖学观察,设计了以冈上肌浅面的斜方肌 相似文献
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骶前区静脉丛的解剖学特点及临床意义 总被引:2,自引:1,他引:1
目的:研究骶前区静脉丛(Venous plexus of presacral region ,VPPSR) 的解剖学特点,为骶前区静脉破裂大出血的防治提供解剖学基础。方法:在34 具成人尸体上,分虽观测VPPSR 的组成、管壁、瓣膜、长度及直径。结果:VPPSR 管壁薄、缺少静脉瓣,呈网状。VPPSR S1~5 横干的长度和直径( F 检验) 均有显著差异,P< 0 .05 。其长度平均( 珋x ±s) :S1 为3 .2 ±1 .5 cm ,S2 为4 .4 ±1 .0 cm ,S3 为3 .5 ±1 .1 cm ,S4 为2 .3 ±0 .9 cm ,S5 为1 .0 ±0 .3 cm ;其直径平均(珋x ±s) :S1 为1 .2 ±0 .7 m m ,S2 为2 .5 ±1 .5 m m ,S3 为2 .5 ±1 .5 m m ,S4为1 .7 ±1 .5 m m ,S5 为0 .9 ±0 .6 m m 。S4 椎体前穿通支静脉口径2 ~4 m m 占8 .8 % ,0 .1 ~1 .9 m m 占91 .2 % 。结论:VPPSR 解剖变异多、血管壁薄、缺少静脉瓣是引起VPPSR 损伤大出血甚至死亡的解剖学基础。 相似文献
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颈部血管医学影像学的应用解剖 总被引:1,自引:1,他引:0
用福尔马林液固定的成尸65具(男60,女5),结合超声诊断选择相同的测点,用卡尺测量了颈总动脉,颈内动脉,颈外动脉及椎动脉和颈内静脉及椎静脉的外径,用千分尺测量了动脉壁厚度,其中各动脉内径:颈总动脉近点为6.3±1.4mm;远点为6.9±1.5mm,颈内动脉为5.5±1.2mm,颈外动脉为4.6±0.7mm,椎动脉椎前部为3.7±0.7mm。并就尸体与活体成人100例用美国产ACUSON128型彩 相似文献
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腓骨上段移植重建第1跖骨的解剖学基础 总被引:7,自引:4,他引:3
目的:为腓骨上段移植重建第1跖骨提供解剖学依据。方法:在30具骨骼标本上,对腓骨上段及第1跖骨进行形态学测量。结果:腓骨上段、第1跖骨形态比较,横径:腓骨头为(2.1±0.3)cm,跖骨头为(2.1±0.2)cm;腓骨颈为(1.1±0.1)cm,跖骨体为(1.4±0.1)cm。长度:腓骨头为(2.2±0.3)cm,跖骨头为( 1.5 ± 0.2)cm。矢状径:腓骨头为(2.6 ± 0. 3)cm,跖骨头为( 1. 9 ± 0. 2)cm。跖骨长度为(5. 8 ± 0. 3)cm。结论:腓骨上段与第1跖骨形态相似,设计带血管的腓骨上段移植重建第1跖骨具有可行性,临床已应用42例,效果满意。 相似文献
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踝跖部神经显微断层解剖及其临床意义 总被引:3,自引:0,他引:3
目的:为不同部位断足再植提供理论基础和有关数据。方法:用体视学方法对66例成人踝跖部胫神经及其重要分支进行观测。结果:胫神经的平均横径和面积分别为:第1断层5.8mm,14.1mm2,足底内侧神经的平均横径和面积分别为:第1断层4.0mm,7.2mm2,第2断层4.1mm,6.8mm2;第3断层4.3mm,6.5mm2;第4断层3.7mm,5.4mm2;第5断层3.1mm,4.4mm2;第6断层3.2mm,4.4mm2;第7断层2.9mm,4.7mm2。足底外侧神经的平均横径和面积分别为:第1断层3.0mm,4.8mm2;第2断层3.1mm,4.5mm2;第3断层3.5mm,4.7mm2;第4断层4.0mm,4.4mm2;第5断层4.5mm,4.6mm2。结论:提出了“三段”断足分型法。不同断层平面断足再植吻接神经时要首选吻接主干,但断层11和12应根据足部感觉功能需要首选吻接胫侧神经。 相似文献
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胰颈的矢状断面解剖及其临床意义 总被引:5,自引:0,他引:5
为给胰腺疾病的断层影像诊断提供解剖学资料,利用30套成年男性腹部连续矢断层标本,研究了胰颈的断面解剖特征。在矢状断面上,胰颈呈椭圆形(80%),三角形(13.3%)和菱形(6.7%)。在肠系膜上静脉出现断面上,胰颈最长前后径2.3±0.6cm,最长上下径3.4±0.7cm。主胰管主要位于胰颈矢状面的中心(56.7%)和中上部(16.7%)和中上部(16.7%),其内径为1.6±0.4mm。此外还详 相似文献
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改良肘关节内侧入路尺侧副韧带手术的应用解剖 总被引:2,自引:0,他引:2
目的:为肘关节经肌肉入路尺侧副韧带(UCL)修复术提供解剖学基础。方法:成人肘关节标本35侧,解剖观察尺侧副韧带前束、肘部屈肌总腱及尺、正中神经分支的解剖关系,并行摹拟手术。结果:UCL前束起于肱骨内侧髁的前下方,止于尺骨冠突内侧的小结节,UCL前束位于尺侧腕屈肌肱头、尺头之间的深层;尺神经在肘管中部与尺侧副韧带前束的平均距离为(0.9 ± 0. 1)cm,在肘管的远侧出口,距尺侧副韧带的尺骨止点(0.6±0.3)cm;尺神经至尺侧腕屈肌尺头肌支的入肌点距肱骨内侧髁的距离为(3.7±0.8)cm;正中神经最靠近切口的分支距切口的距离,在肱骨内侧髁和尺骨结节水平分别为(1.6±0.5)cm和(0.9±0.4)cm。结论:经尺侧腕屈肌的肱头和尺头之间、自肱骨内侧髁向前外侧至UCL尺骨止点以远约2 cm为一损伤较小的安全手术入路。 相似文献
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目的:探讨胸骨下部Y 形小切口心内直视手术的解剖学基础及临床应用。方法:采用胸骨下半部正中劈开,至胸骨角下方2 cm 处向左上、右上方剪开胸骨,使切口成Y 形,行体外循环心内直视手术27 例,观测皮肤切口、胸骨纵切口、显露主动脉、肺动脉、右心及左心范围。结果:患者全部恢复良好,无手术死亡及严重并发症。全组皮肤切口,胸骨纵切口,显露主动脉,显露肺动脉平均长度分别为8 .8 ±1 .8 cm ,8 .1 ±2 .2 cm 、2 .5 ±0 .8 cm 、1 .5 ±0 .6 cm 。全组平均体外循环时间、主动脉阻断时间、手术时间分别为85 ±45 .4 min 、39 .4 ±30 .6 min 、180 .5 ±51 .1 min 。术后平均呼吸机辅助呼吸6 .1 ±5 .6h 、术后第1 天平均出血量150 ±71ml,平均输血量150 ±143ml,术后住院时间9 .7 ±1 .5 天,术后患者无胸骨畸形,切口疤痕小。结论:胸骨下部Y 形小切口心内直视手术显露好,创伤小,出血少,术后恢复快,具有安全性及较好的美容效果。 相似文献
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活体肾上腺血管的解剖观测及临床意义 总被引:3,自引:1,他引:3
目的:研究活体肾上腺血管的应用解剖。方法:对18例24侧肾上腺手术时分离出血管,测量血管外径及长度,对6个完整肾上腺灌注染色。结果:右膈下动脉从下腔静脉右缘至末支肾上腺上动脉长8.5(7.5~11.0)cm,外径2.5~3.0mm;左膈下动脉从腹主动脉左缘至末支肾上腺上动脉长8.0(7.0~9.0)cm,外径2.5~3.1mm;肾上腺上动脉1~6支,均源于膈下动脉。肾上腺中动脉右侧长1.7~2.2cm,外径1.0~1.5mm;左侧长1.5~2.0cm,外径1.0~1.5mm。肾上腺下动脉两侧基本相同,长1.5~2.0cm,外径1.0~2.0mm。肾上腺中心静脉右侧长0.4~0.8cm,左侧长3.0~4.0cm,外径3.0~4.0mm。结论:肾上腺血管加部分膈下血管的长度可供带血管蒂肾上腺转位治疗柯兴氏病;活体切取供移植的肾上腺;选择性肾上腺血管造影等。 相似文献
11.
Malignant nerve sheath tumor of acoustic nerve 总被引:2,自引:0,他引:2
A malignant nerve sheath tumor of the acoustic nerve was found in a 54-year-old man whose right acoustic nerve signs had shown gradual worsening during the previous five years. No stigmata of von Recklinghausen's disease were noted. The tumor at autopsy extensively involved the brain stem, cerebellar hemisphere, tentorium of cerebellum, and cerebral occipitotemporal lobe on the right side. Histologically, the tumor was characterized by extreme hypercellularity, pleomorphism, and high mitotic activity. Ultrastructurally, there was an external lamina around the interdigitated cytoplasm of the tumor cells. Long-spacing collagens and junctional devices were also noted. This case is, to our knowledge, the first reported of a malignant nerve sheath tumor in the acoustic nerve. 相似文献
12.
背景:神经导管技术理论上采用生物或非生物材料预制成合适的管状支架,桥接神经断端两侧,在提供神经再生微环境的同时通过神经诱导、营养作用促进神经再生。
目的:观察组织工程化神经导管修复外周神经损伤的临床效果。
方法:选择24例陈旧性上肢神经损伤患者,以患者自愿原则分2组治疗:试验组采用组织工程化神经导管修复,对照组采用自体周围体表感觉神经移植修复。治疗后随访6个月观察患者肢体神经损伤功能修复效果。
结果与结论:随访6个月后,两组肢体远端感觉运动功能与目测类比疼痛评分均较治疗前改善(P < 0.05),且试验组效果更好(P < 0.05);两组损伤侧感觉与运动神经传导速度均较治疗前改善(P < 0.05),且两组间差异无显著性意义。说明组织工程化神经导管材料符合神经修复导管支架的要求,临床应用疗效肯定。 相似文献
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Long gap peripheral nerve injuries usually require a graft to facilitate axonal regeneration into the distal nerve stump. The use of autografts is often limited because of graft availability and donor-site morbidity. We investigated whether acellular nerve allografts would provide an appropriate channel for the promotion and induction of sciatic nerve regeneration in rats. Axons sprouted from the proximal portion and reached the distal portion in the 1 cm-long grafts by 1 month. The number of axons in the regenerated nerves was similar to that of normal nerves at 1 month. Loading the grafts with betaNGF and VEGF increased the number and mean diameter of axons and neovascularization in the regenerated nerves at 1 month. The motor conduction velocity increased over time and reached 63 +/- 10% of that of normal nerves at 6 months. The nerve injuries treated with the acellular grafts had a significant improvement in motor, nociception, and proprioception function compared to untreated nerves. The results from this study suggest that acellular nerve allografts may be a useful biomaterial for functional peripheral nerve regeneration. 相似文献
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目的:研究去细胞的单环刺缢体壁和同种异体神经所构成的人工组织神经的组织相容性及其修复神经缺损的效果。方法:取大鼠40只随机分成实验组、自体神经组、硅胶管组、正常组。实验组将去细胞的单环刺缢体壁缝合成神经导管,其内充填去细胞的异体神经,修复大鼠10 mm坐骨神经缺损。术后4月,通过大体观察,组织形态学观察,了解该人工组织神经修复大鼠坐骨神经缺损的疗效。结果:该人工组织神经组织相容性良好,神经功能恢复效果正常组>自体神经组>实验组>硅胶管组,实验组疗效与自体神经组接近,明显优于硅胶管组。结论:将去细胞的单环刺缢体壁和同种异体神经制成人工组织神经修复周围神经缺损是可行的。 相似文献
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背景:生物可降解材料制成的神经导管可在体内降解,避免出现的神经卡压等问题,因而受到越来越多的关注。
目的:比较自体神经移植与3种合成可生物降解材料神经导管在修复周围神经损伤的效果差异。
方法:通过电生理学检测,形态学观察等神经恢复效果评价方法,对比分析近年来常用的胶原神经导管、DL-乳酸-ε-己内酯神经导管、聚乙醇酸神经导管与自体神经移植修复周围神经缺损的效果。
结果与结论:虽然神经导管与自体神经移植相比在理论上有其优势的一面,但不同合成材料的神经导管之间在神经功能恢复中存在明显差异性,DL-乳酸-ε-己内酯神经导管修复效果与自体神经移植无明显差异,是较为理想的神经导管材料,聚乙醇酸神经导管因自身的因素影响其降解性能,在3种神经导管中的修复周围神经损伤效果最差,胶原神经导管需要交联剂改善其机械性能,其修复周围神经损伤效果居于前两者之间,因此,这3种神经导管在神经功能再生方面还有潜在的缺陷,不能完全替代自体神经移植,而且3者之间的性价比,还缺少足够的大样本长期随机对照实验结果来验证,还需要进一步的实验观察。 相似文献
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Nerve repair after injury can be effectively accomplished by direct suture approximation of the proximal and distal segments. This is more successful if coadaptation can be achieved without tension. Currently, the gold standard repair of larger deficits is the transplantation of an autologous sensory sural nerve graft. However, a significant disadvantage of this technique is the inevitable donor morbidity (sensory loss, neuroma and scar formation) after harvesting of the sural nerve. Moreover, limitation of autologous donor nerve length and fixed diameter of the available sural nerve are major drawbacks of current autograft treatment. Another approach that was introduced for nerve repair is the implantation of alloplastic nerve tubes made of, for example, poly-l-lactide. In these, nerve stumps of the transected nerves are surgically bridged using the biosynthetic conduit. A number of experimental studies, primarily in rodents, indicate axonal regeneration and remyelination after implantation of various conduits. However, only limited clinical studies with conduit implantation have been performed in acute peripheral nerve injuries particularly on digital nerves. Clinical transfer of animal studies, which can be carefully calibrated for site and extent of injury, to humans is difficult to interpret due to the intrinsic variability in human nerve injuries. This prevents effective quantification of improvement and induces bias in the study. Therefore, standardization of lesion/repair in human studies is warranted. 相似文献
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The aim of this research is to find and to evaluate morphometorically the unmyelinated nerve fibers in the human mandibular nerve using a light microscope. Our report demonstrates for the first time the presence of the unmyelinated nerve fibers of the human mandibular nerve stained by a special method. Our results also indicate that there is a morphometric change with aging in the unmyelinated axons of the nerve. 相似文献
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The human cutaneous sensory map has been a work in progress over the past century, depicting sensory territories supplied by both the spinal and cranial nerves. Two critical discoveries, which shaped our understanding of cutaneous innervation, were sensory dermatome overlap between contiguous spinal levels and axial lines across areas where no sensory overlap exists. These concepts define current dermatome maps. We wondered whether the overlap between contiguous sensory territories was even tighter: if neural communications were present in the peripheral nerve territories consistently connecting contiguous spinal levels? A literature search using peer‐reviewed articles and established anatomy texts was performed aimed at identifying the presence of communications between sensory nerves in peripheral nerve territories and their relationship to areas of adjacent and non‐adjacent spinal or cranial nerves and axial lines (lines of discontinuity) in the upper and lower limbs, trunk and perineum, and head and neck regions. Our findings demonstrate the consistent presence of sensory nerve communications between peripheral nerve territories derived from spinal nerves within areas of axial lines in the upper and lower limbs, trunk and perineum, and head and neck. We did not find examples of communications crossing axial lines in the limbs or lines of discontinuity in the face, but did find examples crossing axial lines in the trunk and perineum. Sensory nerve communications are common. They unify concepts of cutaneous innervation territories and their boundaries, and refine our understanding of the sensory map of the human skin. Clin. Anat. 27:681–690, 2014. © 2013 Wiley Periodicals, Inc. 相似文献
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背景:神经导管是由天然或人工合成材料制成的、用于桥接神经断端的组织工程支架材料,具有引导和促进神经再生作用。
目的:总结近年来常用的神经导管生物材料在神经修复中的应用。
方法:由作者应用计算机检索维普数据库中与神经导管生物材料在神经修复中应用有关的文章,检索时限2002-01/ 2010-12。检索关键词:神经导管;生物材料;神经损伤;神经修复;神经再生。纳入标准:与神经导管生物材料在神经修复中应用有关的文章。排除标准:重复研究或较陈旧文献。根据纳入排除标准共保留相关文献30篇。
结果与结论:非生物降解材料由于其不可吸收性和对再生神经的远期不良影响使临床应用受到限制。生物降解材料在神经再生完成后可在体内降解吸收,无需二次手术取出,但目前未能利用生物降解材料完全仿制出具有天然神经结构的支架。生物衍生材料生物相容性好、排异反应小,可提供细胞外基质、胶原,起支架作用,但缺血后存在管形塌陷、再生不良、吸收瘢痕组织、增生及粘连等问题。神经导管生物材料在神经修复中的应用前景广阔,但单用一类材料难以制作出理想的神经导管生物材料,通过结合各类材料的优点,与神经营养因子、细胞外基质成分和许旺细胞等联合应用,制备新型具有生物活性的导管材料,将有利于神经修复进一步发展。 相似文献
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The presence of voltage gradients within developing and damaged tissues led to the notion that the resultant electrical fields provide instructional cues to cells. Field effects on avian and amphibian neurones in vitro include increased differentiation, turning of neurites towards the cathode, increased rate of growth towards the cathode, resorption of anodefacing neurites, increased branching and increased filopodial activity. Electric fields enhance regeneration of damaged PNS and CNS neurones in animals as diverse as lampreys, frogs, rats and guinea-pigs, but the mechanisms by which fields produce their effects are not understood. Further examination of the interaction of fields with intracellular elements, such as the cytoskeleton and second messenger systems, may offer some insight. 相似文献