肘前内侧血管神经间隙入路的临床解剖学

发布时间：2018-01-19 02:23

本文关键词： 手术入路肘前内侧入路血管神经间隙应用解剖　出处：《中国临床解剖学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的对肘前内侧血管神经等相关结构进行解剖研究,为肘关节相关手术提供更佳的手术入路。方法福尔马林防腐动脉灌注红色乳胶成人尸体上肢标本20侧,按层次解剖,从肱桡肌及旋前圆肌间隙进入,通过正中神经与肱、尺动脉之间的血管神经间隙,显露肘前侧解剖结构。观察肱动脉、桡动脉和尺动脉向内、外侧的分支,测量分支到桡、尺动脉分叉处的距离,分支管径;观察正中神经及分支走行情况,测量神经与血管伴行无相互交叉分支距离。结果血管神经无互相交叉分支伴行长度平均为6.04 cm,两者之间无重要分支相交叉,易于向两侧分开,能够清楚地提供肘关节相应部位的暴露。动脉向内侧分支较向外侧分支少且细,易于向外侧牵拉。神经肌支,基本上向内侧发出,以极小的锐角从主干发出,几乎与主干平行,易于向内侧牵拉。结论肘前内侧血管神经间隙入路,可保护血管神经,能清楚显露肘关节前侧解剖结构,易于操作。
[Abstract]:Objective to study the anatomic structure of anterior medial cubital vessels and nerves in order to provide a better approach for elbow joint operation. Methods 20 adult cadavers with red latex were perfused with formalin anticorrosive artery. The anterior anatomic structure of elbow was revealed through the vascular nerve gap between median nerve, brachial nerve and ulnar artery. The brachial artery, radial artery and ulnar artery were observed inwards. Lateral branch, measure the distance from branch to radial, ulnar artery bifurcation, branch diameter; The median nerve and its branches were observed and the distance between the nerve and the blood vessel was measured. Results the average length of the nerve and the nerve was 6.04 cm. There is no important branch crossing between the two, easy to separate to both sides, can clearly provide the elbow joint of the corresponding part of the exposure. The medial branch of the artery than the lateral branch is smaller and thinner, easy to pull to the lateral, nerve muscle branch. It is almost parallel to the main trunk and easy to pull to the medial side. Conclusion the anterior medial cubital vascular nerve gap approach can protect the blood vessels and nerves. Can clearly expose the anatomic structure of the elbow joint, easy to operate.
【作者单位】：承德医学院附属医院骨外二科;河北医科大学第三医院创伤急救中心;
【基金】：河北省承德市科技支撑计划项目(20157035)
【分类号】：R687.4;R322.7
【正文快照】： 肘前侧入路,由Henry AK首先提出,即为Henry 入路[1],它是从肱桡肌及肱二头肌腱间隙进入,将肱动脉及正中神经及肱二头肌肌腱牵向内侧,肱桡肌牵向外侧,可显露肱骨小头、桡骨头、桡骨颈及桡骨近端,但此入路有需切断肱、桡动脉向桡侧的血管分支,以及易损伤骨间后神经的缺点,并且

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