本文選題：臂叢神經(jīng)　切入點(diǎn)：腋神經(jīng)　出處：《廣西醫(yī)科大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：(一)結(jié)合臨床資料和尸體解剖探討臂叢神經(jīng)損傷中四邊孔處腋神經(jīng)損傷的發(fā)病機(jī)率,為提高神經(jīng)轉(zhuǎn)位修復(fù)腋神經(jīng)的臨床效果提供理論依據(jù)。(二)對(duì)肱三頭肌肌支和腋神經(jīng)進(jìn)行顯微解剖為后入路肱三頭肌肌支轉(zhuǎn)位修復(fù)腋神經(jīng)進(jìn)一步提供解剖學(xué)依據(jù)。 方法：(一)臨床資料：40例臂叢神經(jīng)損傷并有神經(jīng)轉(zhuǎn)位修復(fù)腋神經(jīng)適應(yīng)癥的患者,后入路對(duì)其四邊孔和腋神經(jīng)探查。(二)解剖15具30側(cè)福爾馬林浸泡的成人尸體標(biāo)本,觀察腋神經(jīng)與四邊孔結(jié)構(gòu)的關(guān)系以及對(duì)肱三頭肌肌支顯微解剖。 結(jié)果：(一)臨床資料：12例(30%)腋神經(jīng)損傷。尸體解剖學(xué)：腋神經(jīng)在四邊孔處移動(dòng)范圍小,僅有1cm上下活動(dòng)范圍。26例(87%)四邊孔內(nèi)存在腱性纖維。當(dāng)前下半脫位時(shí),腋神經(jīng)張力增大；前屈、后伸時(shí),腋神經(jīng)緊貼關(guān)節(jié)囊、腱性纖維、肱三頭肌長(zhǎng)頭肌腱,并與之產(chǎn)生磨擦。(二)肱三頭肌肌支解剖學(xué)特點(diǎn)：從內(nèi)→外數(shù)分別是長(zhǎng)頭支、內(nèi)側(cè)頭上支、內(nèi)側(cè)頭下支、外側(cè)頭上支。長(zhǎng)頭支橫徑2.15±0.44mm,長(zhǎng)度BC19.64±4.72mm。內(nèi)側(cè)頭上支橫徑1.65±0.41mm、長(zhǎng)度BC49.80±8.93mm；內(nèi)側(cè)頭下支橫徑1.87±0.32mm、長(zhǎng)度BC85.14±6.75mm；外側(cè)頭上支橫徑1.75±0.31mm、長(zhǎng)度BC43.55±9.17mm。 結(jié)論：(一)臂叢神經(jīng)損傷患者常合并四邊孔處腋神經(jīng)損傷,擬行神經(jīng)轉(zhuǎn)位修復(fù)腋神經(jīng)時(shí),有必要探查其是否損傷。(二)橈神經(jīng)肱三頭肌肌支任一支都可作為供體轉(zhuǎn)位修復(fù)腋神經(jīng),應(yīng)優(yōu)先選用長(zhǎng)頭支。
[Abstract]:Objective to explore the incidence of axillary nerve injury at the foramen quadrilateral in brachial plexus injury by combining with clinical data and autopsy. In order to improve the clinical effect of transposition of nerve to repair axillary nerve. (2) microanatomy of triceps brachii muscle branch and axillary nerve provides anatomic basis for posterior transposition of triceps brachii muscle branch to repair axillary nerve. Methods (1) Clinical data of 40 patients with brachial plexus nerve injury and indications of nerve transposition to repair axillary nerve were retrospectively analyzed. (2) Fifteen adult cadavers with 30 sides of formalin immersion were dissected by posterior approach. The relationship between axillary nerve and quadrangular foramen and microanatomy of triceps brachii muscle branch were observed. Results (1) Clinical data: 12 cases (30 cases) axillary nerve injury. Cadaveric anatomy: axillary nerve moved in a small range at the foramen quadrangularis, with only 1 cm above and below the area of activity. 26 cases had tendon fibers in the quadrilateral foramen. At present, there are tendinous fibers in the quadrilateral foramen. Increased tension of axillary nerve; anterior flexion, extension, axillary nerve close to the capsule of the joint, tendinous fiber, triceps brachii longhead tendon, and produce friction with it. (II) Anatomical characteristics of triceps brachii muscle branch: from the inner part of the triceps muscle. 鈫扵he transverse diameter of the long head branch is 2.15 鹵0.44 mm, the length of the long head branch is BC19.64 鹵4.72 mm, the transverse diameter of the medial superior head branch is 1.65 鹵0.41 mm, the length is BC49.80 鹵8.93 mm, the transverse diameter of the medial inferior head branch is 1.87 鹵0.32 mm, the length is BC85.14 鹵6.75 mm, the transverse diameter of the lateral superior head branch is 1.75 鹵0.31 mm and the length of BC43.55 鹵9.17 mm. Conclusion (1) the patients with brachial plexus injury often have axillary nerve injury at the quadrangular foramen, and when the nerve transposition is to repair the axillary nerve, It is necessary to explore whether it is damaged. (2) any branch of triceps brachii muscle branch of radial nerve can be used as donor to repair axillary nerve, and long head branch should be selected first.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R651.3;R322

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