带血供尺神经深筋膜瓣下前置术的解剖学研究

发布时间：2018-06-03 18:17

本文选题：尺神经深筋膜瓣下前置术 + 肘管综合征　；参考：《山西医科大学》2008年硕士论文

【摘要】： 目的:研究肘部尺神经的伴行供养血管、尺神经分支及肘部前内侧深筋膜血供情况,为带血供尺神经深筋膜瓣下前置术的可行性提供解剖学依据。方法:取6具(男4具,女2具)成人福尔马林防腐处理尸体12侧上肢标本,4具(男3具,女1具)成人新鲜尸体8侧上肢标本,解剖观察肘管结构,查找并观察肘部尺神经分支及其血供,测量对尺神经有供养作用的血管与神经伴行长度及垂直距离。在新鲜尸体上模拟手术操作,将肘部尺神经及其供养血管充分游离后进行前置,测量尺神经可前置的最大距离。解剖肘部前内侧,查找相对恒定的供养该处深筋膜动脉。测量工具为直尺,精度至0.1 cm。结果:肘部尺神经血供来源有3个:尺侧上副动脉(SUCA)、尺侧下副动脉(IUCA)和尺侧返动脉后支(PURA),与尺神经伴行长度分别约为15.5 cm、4.5 cm和5.5 cm。充分游离尺神经和各供养动脉后,尺神经可带血供向前移动至少7cm。尺神经于肘部发出关节支和肌支分别为1～3支。肘部前内侧未能发现恒定的供养该处深筋膜的动脉。结论:行尺神经深筋膜瓣下前置术时至少应保留SUCA或IUCA。深筋膜瓣的制作应依据任意皮瓣原则。
[Abstract]:Objective: to study the collateral feeding vessels, branches of ulnar nerve and anterior medial deep fascia of elbow, and to provide anatomic basis for the feasibility of subvalvular preimplantation of ulnar nerve with blood supply. Methods: 12 upper limb specimens (3 male and 1 female) were collected from 6 adult cadavers (4 males and 2 females), and the cubital tunnel structure was observed. The branches and blood supply of ulnar nerve in the elbow were observed and the degree and vertical distance of the vessels and nerves associated with the ulnar nerve were measured. The ulnar nerve of the elbow and its dependent vessels were prepositioned after the full dissociation of the ulnar nerve and its dependent vessels on the fresh cadavers. The maximum distance from which the ulnar nerve could be prepositioned was measured. Anatomize the anterior medial side of the elbow and search for a relatively constant supply of the deep fascia artery. The measuring tool is a ruler with precision up to 0.1 cm. Results: there were three sources of ulnar nerve blood supply in the elbow: superior ulnar collateral artery (SUCAA), inferior ulnar collateral artery (IUCAA) and posterior branch of recurrent ulnar artery (Pura). The accompanying length of ulnar nerve was about 15.5 cm, 4.5 cm and 5.5 cm, respectively. After fully dissociating the ulnar nerve and the feeding arteries, the ulnar nerve can move forward with blood supply at least 7 cm. The articular and muscular branches of ulnar nerve in the elbow were 1 and 3, respectively. No constant arteries supporting the deep fascia were found on the anterior medial side of the elbow. Conclusion: SUCA or IUCA should be preserved at least in the operation of ulnar nerve deep fascia flap. The manufacture of deep fascia flap should be based on the principle of arbitrary flap.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R322;R651.3

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