游离脐旁皮瓣感觉神经支配的应用解剖

目的:为带感觉神经的游离脐旁皮瓣提供解剖基础。方法:在20例40侧成人躯干标本上,观测下位肋间神经形态,分支和分布规律,以及与脐旁皮瓣手术的应用解剖学要点。结果:脐旁皮瓣的感觉神经支配主要来自①第10、11肋间神经深支的前支;②第8,9,10肋间神经外侧前支。前者穿出腹直肌鞘前叶后在深筋膜中走行较短距离,主要分布于锁中线以内腹前壁皮肤;后者穿出肌肉后在深筋膜中走行较长距离,主要分布于锁中线以外腹前壁皮肤。但两者在锁中线周围互相吻合相连。结论:可设计以第10,11肋间神经深支为神经(?)或以第8～10肋间神经外侧前支为神经(?)的感觉脐旁皮瓣。

Applied Anatomy about Sensate Nerve Distribution of Paraumbilical Flap

Objective: To provide anatomic basis for a free paraumbilical flap with sensate nerve. Methods: Morphology, branch and distribution of inferior thoracic nerve in 40 adult cadaver specimens were observed Results: The sensate nerve distribution came from the deep branch of 10th or 11th thoracic nerve and lateral anterior branch of the 8th to 10th thoracic nerve. The former run shorter distance in deep fascia and mainly distributed within midclavicular line after piece anterior sheath, the later run longer distance in deep fascia and distributed in lateral of midclavicular line. Their terminal branch joined each other by anatomosis near midclavicular line. Conclusion: It is possible to design a sensate paraumbilical flap with deep branch of 10th or llth thoracic nerve or lateral branch of 8th to 10th thoracic nerve.