后路副神经移位术重建肩外展功能的解剖学研究

发布时间：2018-02-11 22:43

本文关键词： 臂丛副神经神经移位解剖学研究　出处：《广西医科大学》2007年硕士论文　论文类型：学位论文

【摘要】： 目的:对斜方肌内的神经支配进行解剖学研究,为寻找副神经移位到肩胛上神经的最佳移位点和移位方式提供解剖依据。方法:选用成人尸体标本10具20侧,观察斜方肌的神经支配,观察副神经在斜方肌内的行径及分支。并切取副神经、肩胛上神经做不同水平横断面病理切片,计数各神经断面的神经纤维数,并进行比较。结果:副神经在锁骨上2-3cm进入斜方肌,在深面筋膜内斜向后走行。在肩胛冈中点前上方3—4cm处,有来自颈丛的交通支加入后形成终末支,然后越过肩胛冈内侧端直线向下走行至斜方肌下部。副神经在颈丛交通支汇入前发出2-4支较大的肌支支配斜方肌上部,汇入后沿途发出4—7个小分支支配斜方肌下部肌肉。副神经的神经纤维计数:副神经入肌点处(A点)为1245±46条,颈丛的交通支汇入前B点为830±36条,后路手术切断点C为1074±38条。结论:后进路副神经移位术解剖恒定,操作简单,该术式不影响斜方肌上部神经支配,充分利用了颈丛交通支,且缩短了神经再生距离,值得推广。与颈丛交通支合干后,副神经在H-G段分支少,因此损失的神经纤维数少,故H-G段是副神经的最佳移位点。
[Abstract]:Objective: to study the innervation of trapezius muscle and provide anatomic basis for finding the best point and mode of transposition of accessory nerve to suprascapular nerve. Methods: the nerve innervation of trapezius muscle was observed on 20 sides of 10 cadavers of adult cadavers, and the behavior and branch of accessory nerve in trapezius muscle were observed. The number of nerve fibers in each nerve section was counted and compared. Results: the accessory nerve entered the trapezius muscle 2-3 cm above the clavicle and ran diagonally backward in the deep gluten. At the point 3 to 4 cm above the midpoint of scapula, a branch of communication from the cervical plexus was added to form the final branch. Then straight down across the medial end of the scapula to the lower part of the trapezius. The accessory nerve emits 2-4 larger muscle branches to the upper part of the trapezius before the communicating branches of the cervical plexus converge. The number of nerve fibers in the accessory nerve was 1245 卤46, 830 卤36, and 1074 卤38, respectively, and the number of nerve fibers in the accessory nerve was 1245 卤46, 830 卤36, and 1074 卤38 respectively. Conclusion: the posterior approach of accessory nerve transposition is stable in anatomy and simple in operation. It does not affect the superior trapezius nerve innervation, makes full use of the communicating branch of the cervical plexus, and shortens the nerve regeneration distance, so it is worth popularizing. The number of nerve fibers lost in H-G segment is less than that in H-G segment, so H-G segment is the best transposition point of accessory nerve.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R322;R651.3

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