手掌部动脉的构筑

本文在手术显微镜下,观察和测量了50侧成人手掌部的动脉。手掌部的动脉,以掌浅层动脉、掌深层动脉和手背动脉形成3个主要血管层次。各层次间的吻合有:1.边缘吻合:位于手掌桡侧和尺侧缘,有浅,深2组。2.中央吻合,包括掌侧浅、深层间的直接交通支和间接交通支;掌侧和背侧间的近侧穿支、掌骨间隙穿支和远侧穿支。掌深弓及分支住手掌动脉构筑中居中间联系位置,对手掌部侧副循环的调节有重要作用。根据Poiscuille定律的流量公式,结合手掌动脉的形态特点推论,手掌部动脉的血液灌流,浅层以尺动脉为主,深层以桡动脉为主;边缘吻合的血液是从掌侧流向背侧;中央吻合的血流主要来自掌深弓及其分支。手掌部动咏的配布存在优势区域。深弓区优于浅弓区和手背动脉网区;中央吻合优于边缘吻合;边缘深层吻合优于浅层吻合。本文还讨论了指动脉的配布。

THE ARTERIAL ARCHITECTURE OF THE PALMAR PART OF THE HAND

The arteries of the palmar part of the hand were examined in 50 hands of adult under the operating microscope.The arteries of the hand are arranged at three main levels: the superficial palmar arteries, the deep palmar arteries and the dorsal network. The arterial anastomoses between the levels may be divided into 2 groups: the marginal and the central anastomoses, the former which is situated at the radial and ulnar borders of the palm can be subdivided into superficial and deep groups, the latter is located in the central part of the palm including the direct and indirect anastomostic branches, the proximal and distal perforating branches, and the intermetacarpal perforating branches. The deep arch and its branches, as the center in the total arterial architecture of the palmar part of the hand, closely links with the arteries of the superficial and dorsal ones, playing an important role in regulating the collateral circulation of the hand.The flow formula of the Poiseuille's law indicates that the significant correlation exists between the arterial diameter and the blood flow. For the variety of diameter of each portion of the anastomostic branches, we inferred that the main source of blood flow in the superficial arteries is the ulnar artery and in the deep is the radial artery. The blood within the marginal anastomoses flows from palmar to dorsal, the central mainly from the deep arch and its branches.The dominant parts of the collateral circulation of the hand were found, that is, the deep arch dominantes over the superficial arch and the dorsal network, the central anastomosis over the marginal, the deep branches of the marginal over the superficial branches.The arrangement of the digital arteries has been discussed.