手掌部动脉的微型计算机三维重建及其临床意义

成人上肢标本30例,经肱动脉注入遮光色素,作手部动脉造影,然后制成连续的断面标本并摄影。应用微型计算机进行测量并三维重建动脉网。在各断面解剖追踪予以印证。手掌部的动脉由掌浅、掌深和掌背3个层次构成支架。在桡、尺方向上有3条大吻合支,掌、背方向上有3组吻合带,从而形成以掌深弓为中心的在三维空间6个方向都有动脉支连通的立体网络系统。在横断面上的配布型式,按主支的排列位置,在腕掌部可分四型,在掌中部和掌指部可各分为三型。根据动脉支的来源、口径、供区和吻合情况,讨论了腕掌、掌中和掌指3个部位的血供特点以及断掌再植时吻接动脉选择的主与次。

Micro-computerized Three-dimensional Reconstruction of the Palmar Arteries and Its Clinical Significance

30 adult upper extremity specimens are used to study the arteries of the hand by angiography, cross-sectional dissection and three-dimentional reconstruction with a microcomputer. The arterial skeleton of the palm is composed of superficial, deep and dorsal planes. There are 3 main anastomotic pathways between the radial and ulnar arteries or their branches in the radio-ulnar direction, while in the palmar dorsal direction there are 3 anastomotic zones between the palmar and dorsal arterial planes. The branches of the deep palmar arch radiate distally, proximally, palmarly and dorsally. So the palmar arch acts as the center of the arterial network of the hand. The transverse arterial allocations in the carpo-metacarpal segment of the palm are 4 in types, but in the midpalmar and metacarpo-phalangeal segments are 3 only. According to the sources, cross section area, irrigation territories and anastomoses of the arteries in each segment, the clinical significance in the replantation of the amputated palms is discussed.