肱二头肌腱膜处的应用解剖学研究

发布时间：2018-10-30 17:10

【摘要】：目的：研究肱二头肌腱膜的起点，止点，走向，形态，厚度等相关解剖学数据，以及与肱二头肌腱膜相毗邻的血管神经的走形，分布以及与肱二头肌腱膜的关系。以期更好的理解肱二头肌腱膜处的解剖学结构，为临床上在肘窝处进行各类操作、手术及关节镜的应用等，提供相应的解剖学数据资料。材料与方法： 30具（男性20例，女性10例，，共60侧）福尔马林固定的教学用成人尸体标本，尸体标本完整，手臂保留完好，研究区域无器质性病变和明显畸形，年龄不详。观察记录肱二头肌腱膜的相关数据，以及与肱二头肌腱膜相毗邻的结构的解剖学关系。结果： 1.头静脉在肘横纹下方4cm处的外径为3.18±0.62mm，肘横纹处的外径为2.41±0.28mm，在肘横纹上方4cm处的外径为2.32±0.35mm。 2.贵要静脉在肘横纹下方4cm处的外径为1.90±0.16mm，肘横纹处的外径为2.10±0.24mm，在肘横纹上方4cm处的外径为2.26±0.19mm。 3.肘正中静脉在与头静脉的汇合处外径为1.92±0.23mm，在与贵要静脉汇合处的外径为2.36±0.31mm，在走行中段的外径为1.86±0.24mm。 4.肘正中静脉的单干型占57%，双干型占3%，M型占28%，肘正中静脉缺如者占12%。 5.肱二头肌腱膜为一上窄下宽的膜性结构，起始处较窄，宽度为16.80±3.62mm，末端较宽，宽度为42.00±8.16mm，其内侧缘长68.26±10.16mm，外侧缘长84.42±16.35mm。 6.肱二头肌腱膜的深面有肱动脉，正中神经穿过，肱动脉在穿入肱二头肌腱膜处，外径为4.96±0.69mm，穿出肱二头肌腱膜处，外径为4.92±0.78mm；正中神经在穿入肱二头肌腱膜处外径为6.44±1.36mm，穿出肱二头肌腱膜处外径为8.90±2.04mm。结论： 1.进行PICC时，头静脉不宜作为静脉穿刺的首选静脉。 2.进行PICC时，贵要静脉为首选静脉，以肘横纹上方一横指贵要静脉走形处为进针点为宜。 3.临床上行切开肱二头肌腱膜减压术治疗正中神经卡压症时，要由外侧进行切割，注意避免损伤肱二头肌腱膜深面结构。
[Abstract]:Objective: to study the anatomic data of the aponeurosis of biceps brachii. In order to better understand the anatomical structure of the aponeurosis of biceps brachii muscle, provide the anatomic data for clinical operation, operation and arthroscopy in the cubital fossa. Materials and methods: 30 adult cadavers (male 20, female 10, 60 sides) were fixed with formalin. The cadavers were intact and the arms were intact. There were no organic lesions and obvious deformities in the study area, and the age was unknown. The relative data of the aponeurosis of biceps brachii and the anatomical relationship between the aponeurosis of biceps brachii and the aponeurosis of biceps brachii were observed. Results: 1. The external diameters of the cephalic veins were 3.18 卤0.62mm, 2.41 卤0.28mm and 2.32 卤0.35mm. the diameter of the cephalic veins was 3.18 卤0.62mm, 2.41 卤0.28mm and 2.32 卤0.35mm. 2. The external diameters of 4cm, 4cm and 4cm were 1.90 卤0.16mm, 2.10 卤0.24mm and 2.26 卤0.19mm. 3. The external diameter of the median elbow vein was 1.92 卤0.23mm at the confluence with the cephalic vein, 2.36 卤0.31mm at the junction with your main vein, and 1.86 卤0.24mm. 4. In the middle elbow vein, 57 cases were in the trunk type, 28 in the double trunk type, 28 in the M type, and 12 in the middle cubital vein. 5. The aponeurosis of biceps brachii was a membranous structure with a narrow upper and lower width, with a width of 16.80 卤3.62 mm at the beginning, a wider end (42.00 卤8.16 mm), a length of 68.26 卤10.16 mm on the medial margin and a length of 84.42 卤16.35 mm on the lateral margin. 6. There was brachial artery in the deep surface of biceps brachii aponeurosis. The brachial artery penetrated through the aponeurosis of biceps brachii. The external diameter of brachial artery was 4.96 卤0.69 mm, and the outer diameter was 4.92 卤0.78 mm in the aponeurosis of biceps brachii. The external diameter of median nerve was 6.44 卤1.36mm at the aponeurosis through biceps brachii and 8.90 卤2.04mm. through the aponeurosis of biceps brachii. Conclusion: 1. For PICC, the cephalic vein is not the first choice for venipuncture. 2. In PICC, your vein is the first choice. 3. In the treatment of median nerve entrapment by incision of the aponeurosis of biceps brachii, the lateral incision should be performed to avoid damage to the deep surface of the aponeurosis of biceps brachii.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R322

【相似文献】