掌背动脉皮支皮瓣临床解剖学研究

发布时间：2018-12-07 17:00

【摘要】：目的本实验通过对掌背动脉及其皮支的起止、走行、数量、血管外径、血供分布范围、交通吻合情况进行解剖观测，为临床仅以掌背动脉远端皮支为蒂而不必携带掌背动脉的掌背皮瓣的临床应用提供解剖学依据。方法在20侧经动脉灌注红色天然橡胶乳浆灌注液的新鲜成人尸体手标本上，应用手术显微镜系统解剖观测掌背动脉及其皮支的起止、走行、数量、血管外径、血供分布范围、交通吻合情况；观察掌背动脉与伸肌腱的走行关系；观察掌背动脉皮支与伸肌腱的位置毗邻关系。结果掌背动脉共有4条。第1掌背动脉由桡动脉发出，示指桡背侧动脉是第1掌背动脉的延续，起点外径为0.68mm±0.12mm，末端外径为0.42mm±0.10mm，平均长度为53.22mm±5.20mm。掌深弓近侧穿支经第2、3、4掌骨间隙向背侧穿出后，随即分为上行支(亦称近侧支)和下行支(亦称远侧支)。其上行支与腕背动脉网分支相互交通吻合，构成第2、3、4腕背吻合支。其下行支构成第2、3、4掌背动脉，于掌骨头附近分成3条终末支：1条与指总动脉的交通支(亦称指蹼动脉)和2条相邻两指相对侧的指背动脉。交通支与相应的指总动脉或指固有动脉相互交通吻合，指背动脉与指固有动脉的背侧支相互交通吻合，形成指背动脉网。掌背动脉与掌侧动脉之间有3条交通支相连，分别位于掌骨基底(即掌背动脉起始)、掌骨颈部和近节指骨底。第2、3、4掌背动脉起点血管外径分别为0.90mm±0.30mm、0.80mm±0.14mm、0.50mm±0.10mm，末端血管外径分别为0.60mm±0.20mm、0.38mm±0.12mm、0.40mm±0.12mm，平均长度分别为56.80mm±8.20mm、52.20m±5.40mm、40.00mm±8.22mm。各掌背动脉在行程中发出7～12条皮支营养手背部的皮肤；发出2～5条肌腱支呈弓状走行于伸肌腱周组织内，阶段性营养伸肌腱；发出2～4条骨膜支营养骨膜
[Abstract]:Objective to observe the origin, movement, number, diameter, distribution of blood supply and anastomosis of the dorsal metacarpal artery and its cutaneous branches. To provide anatomic basis for clinical application of dorsal metacarpal flap pedicled only with the cutaneous branch of dorsal metacarpal artery without carrying dorsal metacarpal artery. Methods 20 fresh adult cadavers with transarterial infusion of red natural rubber emulsion were used to observe the onset and termination of dorsal metacarpal artery and its cutaneous branches, the number, the diameter of blood vessel and the distribution range of blood supply. Traffic anastomosis; The relationship between dorsal metacarpal artery and extensor tendon and the position of cutaneous branch and extensor tendon of dorsal metacarpal artery were observed. Results there were 4 dorsal palmar arteries. The first dorsal metacarpal artery came from the radial artery, indicating that the dorsal radial artery of the finger was a continuation of the first dorsal metacarpal artery. The external diameter of the first dorsal metacarpal artery was 0.68mm 卤0.12 mm, the outer diameter of the end was 0.42mm 卤0.10 mm, and the average length was 53.22mm 卤5.20 mm. The proximal perforating branch of deep metacarpal arch was divided into ascending branch (proximal branch) and descending branch (distal branch) immediately after perforating to the dorsal side of metacarpal space. The ascending branch anastomosed with the branches of the dorsal carpal artery network. The descending branch of the artery consists of the 4th dorsal metacarpal artery, which is divided into three terminal branches near the metacarpal bone: one communicating branch of the common digital artery (also known as the webbed artery) and two dorsal digital arteries adjacent to the opposite side of the two fingers. The communicating branches were anastomosed with the corresponding common digital artery or digital artery, and the dorsal digital artery was anastomosed with the dorsal branch of the digital artery to form a network of dorsal digital arteries. There are three communicating branches between dorsal palmar artery and palmar artery, which are located at the base of metacarpal bone (starting of dorsal metacarpal artery), neck of metacarpal bone and the base of proximal phalangeal bone. The external diameters of the starting vessels of the dorsal metacarpal artery were 0.90mm 卤0.30mm, 0.80mm 卤0.14mm, 0.50mm 卤0.10mm, 0.60mm 卤0.20mm, 0.38mm 卤0.12mm and 0.40mm 卤0.12mm, respectively. The average length of the vessels was 56.80mm 卤8.20mm. 52.20m 卤5.40mm, 40.00mm 卤8.22mm. Each dorsal metacarpal artery gave off 712 cutaneous branches to nourish the skin of the back of the hand; 2 tendinous branches were issued arcuate through the tissues around the extensor tendons, and 2 periosteal branches were issued to nourish the periosteum.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322

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