本文關(guān)鍵詞： C7神經(jīng) 神經(jīng)移位 頸椎 解剖學(xué)　出處：《南華大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過建立椎體前通路，觀察健側(cè)C7神經(jīng)能否顯著縮短橋接神經(jīng)長度并在此基礎(chǔ)上實(shí)現(xiàn)與目標(biāo)神經(jīng)的直接吻合；同時(shí)探尋是否存在一條較椎體前通路相對(duì)簡單安全且路徑更短的通路。 方法：選取10具20側(cè)正常成人尸體頸段標(biāo)本，將雙側(cè)臂叢充分顯露，遠(yuǎn)端向C7神經(jīng)根前后股進(jìn)行干支分離，在前后股加入外側(cè)束及后束前將其切斷，近端向椎間孔處游離，測(cè)量C7神經(jīng)根從椎間孔至分股處的長度及C7神經(jīng)至前后股長度，測(cè)量并記錄C7神經(jīng)根經(jīng)椎體前通路、頸前皮下通路到對(duì)側(cè)臂叢上、下干的距離；同時(shí)進(jìn)一步解剖顯露頸后部，觀察頸后部的組織結(jié)構(gòu)并探索建立頸椎后通路，同時(shí)通過此通路測(cè)量C7神經(jīng)經(jīng)頸椎后通道至對(duì)側(cè)上下干的缺損距離。 結(jié)果：C7神經(jīng)根的長度（58.62±8.70）mm；C7神經(jīng)前、后股的長度分別為（70.03±10.79）mm，（65.15±9.11）mm；測(cè)量C7神經(jīng)根經(jīng)頸前皮下、椎體前通路、頸椎后通路至對(duì)側(cè)上干的缺損長度分別是（98.18±10.18）mm，（32.10±11.49）mm，（43.22.±5.96） mm，且經(jīng)椎體前通路至對(duì)側(cè)上干所需橋接神經(jīng)的長度明顯短于經(jīng)皮下通路、經(jīng)頸椎后通路，且差異有統(tǒng)計(jì)學(xué)意義（P0.01）；C7神經(jīng)根經(jīng)頸前皮下、椎體前通路、頸椎后通路至對(duì)側(cè)下干的缺損長度分別是（107.14±9.88）mm，（37.28±10.01）mm，（54.31±7.80）mm；且經(jīng)椎體前通路至對(duì)側(cè)下干所需橋接神經(jīng)的長度明顯短于經(jīng)皮下通路、經(jīng)頸椎后通路，差異有統(tǒng)計(jì)學(xué)意義（P0.01）；觀察頸后部解剖特點(diǎn)，發(fā)現(xiàn)于頸后區(qū)建立通路周圍無重要的血管及神經(jīng)。 結(jié)論：較傳統(tǒng)頸前皮下通路，健側(cè)C7神經(jīng)移位經(jīng)椎體前通路能明顯縮短橋接神經(jīng)長度，有效利用了C7神經(jīng)，，但未能減少神經(jīng)吻合口，未能實(shí)現(xiàn)C7神經(jīng)與目標(biāo)神經(jīng)的直接吻合；較椎體前通路，頸椎后通路降低了損傷血管神經(jīng)的風(fēng)險(xiǎn)，較椎體前通路相對(duì)安全，但較其沒有縮短C7神經(jīng)與目標(biāo)神經(jīng)之間的距離。
[Abstract]:Objective: to establish whether the C7 nerve can significantly shorten the length of bridging nerve and achieve direct anastomosis with the target nerve based on the establishment of the anterior vertebral access. Meanwhile, we need to find out whether there is a relatively simple and safe path with a shorter path than the anterior vertebral artery.
Methods: 10 normal adult cadavers with 20 lateral cervical specimens, the bilateral brachial plexus were fully revealed, distal to the C7 nerve root before and after the separation of heavenly stems and Earthly Branches in stocks, stocks added before and after lateral beam and beam before it is cut off, the proximal free to the intervertebral foramen, measuring C7 nerve root from the intervertebral foramen to split. The length and C7 before and after femoral nerve to measure and record the length of the C7 nerve root by anterior pathway, anterior cervical subcutaneous pathway to the contralateral brachial plexus, under dry distance; and further anatomical structure observation revealed the back of the neck, the back of the neck and explore the establishment of cervical posterior pathway through this pathway and defect distance measurement C7 nerve to the contralateral posterior channel on stem.
緇撴灉錛欳7紲炵粡鏍圭殑闀垮害(58.62鹵8.70)mm錛汣7紲炵粡鍓

本文編號(hào)：1444400