TFCC神经分布的解剖和免疫荧光研究

发布时间：2018-06-29 04:01

本文选题：TFCC + 尺侧腕痛　；参考：《吉林大学》2011年硕士论文

【摘要】：目的： TFCC作为一个韧带软骨复合体,对维系远端尺桡关节的稳定性具有重要作用,其损伤是尺侧腕痛的常见病因,并影响尺腕关节功能。通过对10例成人上肢标本的解剖和免疫荧光染色技术,对腕关节TFCC的神经来源、内部神经分布进行观察,为尺侧腕痛提供病因基础,进而为其临床治疗提供解剖学依据。方法：分别对2例成人新鲜标本和8例10%福尔马林固定的成人上肢标本进行显微解剖,10倍显微镜下观察TFCC的神经来源、分布。用大鼠抗人单克隆PGP9.5抗体和Cy3标记的山羊抗大鼠IgG,通过免疫荧光染色技术,对TFCC内部神经分布行定量观察。同时对几个切片进行HE染色,观察TFCC的大体结构。结果：通过标本的显微解剖发现,尺神经手背支和前臂内侧皮神经神经均有分支到腕关节尺侧,其中5例前臂内侧皮神经发1个分支至TFCC表面,3例有2个分支至TFCC;1例尺神经手背支发1个分支至TFCC,3例有2个分支,3例3个分支,3例4个分支。尺神经手背支和前臂内侧皮神经可同时支配TFCC。免疫荧光染色发现TFCC内神经主要分布在IP,桡侧没有神经分布。结论： TFCC的神经可来自于前臂内侧皮神经和尺神经手背支,不受单一神经支配,其内部神经主要分布在尺侧,尤其是IP部分,顽固性尺侧腕痛可以行去神经支配术。
[Abstract]:Objective: as a ligamentous cartilage complex, TFCC plays an important role in maintaining the stability of distal ulnar radial joint. The injury of TFCC is a common cause of ulnar carpal pain and affects the function of ulnar wrist. The nerve source and internal nerve distribution of TFCC in wrist joint were observed by dissection and immunofluorescence staining in 10 adult upper limb specimens, which provided the etiological basis for ulnar carpal pain and anatomic basis for its clinical treatment. Methods: 2 fresh adult specimens and 8 adult upper limb specimens fixed with 10% formalin were observed under microdissection and 10 times microscope to observe the nerve origin and distribution of TFCC. Rat anti-human monoclonal PGP 9.5 antibody and goat anti-rat IgG labeled by Cy3 were used to quantitatively observe the nerve distribution in TFCC by immunofluorescence staining. At the same time, some sections were stained with HE to observe the gross structure of TFCC. Results: it was found that the dorsal branch of ulnar nerve and the medial cutaneous nerve of forearm had branches to the ulnar side of wrist joint. In 5 cases, 1 branch of medial cutaneous nerve of forearm to surface of TFCC was found in 3 cases. 2 branches to 1 branch of dorsal branch of ulnar nerve to 3 cases of TFCC nerve were found in 3 cases, 3 branches in 3 cases, 4 branches in 3 cases. The dorsal branch of ulnar nerve and medial cutaneous nerve of forearm can innervate TFCC simultaneously. Immunofluorescence staining showed that the nerves in TFCC were mainly distributed in IPs, but there was no nerve distribution in the radial side. Conclusion: the nerves of TFCC can come from the medial cutaneous nerve of forearm and dorsal branch of the ulnar nerve and are not innervated by a single nerve. The internal nerve is mainly distributed in the ulnar side, especially in the IP part. Obstinate ulnar carpal pain can be innervated by denervation.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R686.5;R322.8

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