中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2015年
2期
149-151
,共3页
丁健%李志杰%陶先耀%王珑%封晓亮
丁健%李誌傑%陶先耀%王瓏%封曉亮
정건%리지걸%도선요%왕롱%봉효량
拇短屈肌肌支%正中神经返支%神经移位%尺神经深支%应用解剖
拇短屈肌肌支%正中神經返支%神經移位%呎神經深支%應用解剖
무단굴기기지%정중신경반지%신경이위%척신경심지%응용해부
Flexor pollicis brevis branch%Recurrent branch of median nerve%Nerve transfer%Profundus nervi ulnaris%Applied anatomy
目的 探讨正中神经拇短屈肌肌支移位于尺神经深支的解剖学依据. 方法 新鲜成人上肢8侧,首先对标本的腕、手部进行显微解剖,观察拇短屈肌肌支的数量,游标卡尺测量拇短屈肌肌支到豌豆骨距离以代表神经的再生距离,并在尸体上模拟拇短屈肌肌支移位到尺神经深支的手术.切取神经标本予以苏木精-伊红(HE)染色,使用图像处理软件Image-Pro Plus version 6.0测量有髓神经纤维横截面积、密度并计算有髓神经纤维数量.数据通过SPSS 17.0软件进行统计学分析. 结果 拇短屈肌肌支无缺失,其中2侧标本肌支为两支,6侧标本肌支为一支.在所有的尸体标本中拇短屈肌肌支移位至尺神经深支后均可进行无张力缝合,移位后再生距离为(37.3±5.76)mm.拇短屈肌肌支和尺神经深支有髓神经的横截面积分别为(0.0575±0.0086)mm2和(0.2039±0.0396)mm2、数量分别为(492.50±62.62)条和(1651.13±79.01)条、密度分别为(8781.4246±1676.2894)条/mm2和(8371.1592±1677.6509)条/mm2.有髓神经纤维横截面积和数量差异均有统计学意义(P＜0.05),但两者有髓神经纤维密度差异无统计学意义(P＞ 0.05). 结论 拇短屈肌肌支移位术可提供较短的再生距离,但是只能满足部分尺神经深支神经纤维的再生.
目的 探討正中神經拇短屈肌肌支移位于呎神經深支的解剖學依據. 方法 新鮮成人上肢8側,首先對標本的腕、手部進行顯微解剖,觀察拇短屈肌肌支的數量,遊標卡呎測量拇短屈肌肌支到豌豆骨距離以代錶神經的再生距離,併在尸體上模擬拇短屈肌肌支移位到呎神經深支的手術.切取神經標本予以囌木精-伊紅(HE)染色,使用圖像處理軟件Image-Pro Plus version 6.0測量有髓神經纖維橫截麵積、密度併計算有髓神經纖維數量.數據通過SPSS 17.0軟件進行統計學分析. 結果 拇短屈肌肌支無缺失,其中2側標本肌支為兩支,6側標本肌支為一支.在所有的尸體標本中拇短屈肌肌支移位至呎神經深支後均可進行無張力縫閤,移位後再生距離為(37.3±5.76)mm.拇短屈肌肌支和呎神經深支有髓神經的橫截麵積分彆為(0.0575±0.0086)mm2和(0.2039±0.0396)mm2、數量分彆為(492.50±62.62)條和(1651.13±79.01)條、密度分彆為(8781.4246±1676.2894)條/mm2和(8371.1592±1677.6509)條/mm2.有髓神經纖維橫截麵積和數量差異均有統計學意義(P＜0.05),但兩者有髓神經纖維密度差異無統計學意義(P＞ 0.05). 結論 拇短屈肌肌支移位術可提供較短的再生距離,但是隻能滿足部分呎神經深支神經纖維的再生.
목적 탐토정중신경무단굴기기지이위우척신경심지적해부학의거. 방법 신선성인상지8측,수선대표본적완、수부진행현미해부,관찰무단굴기기지적수량,유표잡척측량무단굴기기지도완두골거리이대표신경적재생거리,병재시체상모의무단굴기기지이위도척신경심지적수술.절취신경표본여이소목정-이홍(HE)염색,사용도상처리연건Image-Pro Plus version 6.0측량유수신경섬유횡절면적、밀도병계산유수신경섬유수량.수거통과SPSS 17.0연건진행통계학분석. 결과 무단굴기기지무결실,기중2측표본기지위량지,6측표본기지위일지.재소유적시체표본중무단굴기기지이위지척신경심지후균가진행무장력봉합,이위후재생거리위(37.3±5.76)mm.무단굴기기지화척신경심지유수신경적횡절면적분별위(0.0575±0.0086)mm2화(0.2039±0.0396)mm2、수량분별위(492.50±62.62)조화(1651.13±79.01)조、밀도분별위(8781.4246±1676.2894)조/mm2화(8371.1592±1677.6509)조/mm2.유수신경섬유횡절면적화수량차이균유통계학의의(P＜0.05),단량자유수신경섬유밀도차이무통계학의의(P＞ 0.05). 결론 무단굴기기지이위술가제공교단적재생거리,단시지능만족부분척신경심지신경섬유적재생.
Objective To explore the anatomical basis for the flexor pollicis brevis branch of median nerve transfer to the deep branch of ulnar nerve.Methods Eight fresh upper limb were dissected and observed.The specimen were dissected under the loup.Observed the number of the flexor pollicis brevis branch and measured the distances from pisiform bone to the flexor pollicis brevis branch.Then the transfer operation on the cadaver were imitated.After the anastomosis was completed,the stumps of the nerves were sectioned and stained with HE.The crossing-sectional area and the density of nerve fiber were obtained by Image-Pro Plus version 6.0,then the number of the nerve fiber were calculated.The data analyzed by SPSS 17.0.Results The flexor pollicis brevis branch constantly appear,there were two branches in 2 specimens,one branch in 6 specimens.The flexor pollicis brevis branch could transfer to the deep branch of ulnar nerve by end-to-end surture without tension.The regeneration distances was (37.3 ± 5.76) mm.The crossing-sectional area were (0.0575 ± 0.0086)mm2 and (0.2039 ± 0.0396)mm2,the number were (492.50± 62.62) and (1651.13± 79.01),the density were (8781.4246 ± 1676.2894)/mm2 and (8371.1592 ± 1677.6509)/mm2 in the flexor pollicis brevis branch and the deep branch of ulnar nerve,respectively.There were no significant differences in the density of the nerve fiber between the donor and recipient nerve (P ＜0.05).But there were differences in the crossing-sectional area and number of the nerve fiber(P ＜ 0.05).Conclusion The flexor pollicis brevis branch transfer to the deep branch of ulnar nerve can provide a short regenerating distance,but can supply a part of recipient nerve to reinnervate.
