带尺侧上副动脉尺神经转位的解剖及临床意义

目的为临床上带血管蒂的尺神经移植在健侧颈7移位治疗臂丛根性撕脱伤中的应用提供解剖学依据。方法取新鲜经动脉灌注红色乳胶的成人上肢标本22侧进行显微解剖，观察尺神经外部营养动脉的来源。另取患骨肿瘤而截肢新鲜成人上肢6侧作仅保留尺侧上副动脉的尺神经游离，采用动脉灌注墨汁和尺神经组织切片的方法，观察尺侧上副动脉对尺神经内部血供营养的范围。结果尺神经在腋部由胸外侧或腋动脉的分支供应，在内侧肌间隔后方由尺侧上副动脉供应，在尺神经沟由尺侧上副动脉与尺侧返动脉后支的吻合支供应，在前臂由尺侧返动脉和尺动脉的分支供应。尺侧上副动脉灌注墨汁后，尺神经腕部、手背支及腋部的神经束内微血管被墨汁充填。结论以尺侧上副动脉的起始处为血管蒂部旋转点，尺神经可提供平均为(46.5±2.6)cm的有血供的移植长度，可经胸前皮下隧道逆向转位与对侧颈7神经根吻合。以尺侧上副动脉为血供的尺神经移植的设计是合理的。

The anatomical study ofvascularized ulnar nerve graft pedicled with the superior collateral ulnar artery

Objective:To provide anatomical basis for the vascularized ulnar nerve graft pedicled with the superior collateral ulnar artry(SCUA).Methods:Fresh cadaver upper extremities injected with latex by arties were dissected to study the extrinsic blood supply of ulnar nerve.Other 6 fresh upper extremities were used to analyze the blood supply range of SCUA inside the ulnar nerve by microangiographic and histological methods.Results:The ulnar nerve wes supplied by a branch of the latetral thoracic artety or directly by the axillary artery in the axillary section,by the branches of the SCUA in the upper arm,by the branches from the anastomosis of the collartetal arteries and the posterior branch of the recurrent ulnar artery in the elbow. The SCUA can supply the whole ulnar nerve form axillary to wrist.Conclusion: Regarding the beginning of the SCUA as the rotating point of the pedicle,the length of ulnar nerve which can be graft is 46.5±2.6 cm.The ulnar nerve can be used as a vascularized nerve graft by the pedicle of the SCUA in the treatment of brachial plexus roots avulsion by C7 transfer from healthy side.