本文選題：肌皮神經(jīng) + 易卡壓點(diǎn)　； 參考：《吉林大學(xué)》2012年碩士論文

【摘要】：目的:報(bào)道肌皮神經(jīng)卡壓征一例，并通過對常人尸體解剖，對肌皮神經(jīng)進(jìn)行形態(tài)學(xué)研究，得出肌皮神經(jīng)易卡壓點(diǎn)的解剖學(xué)變化。方法對1例肌皮神經(jīng)卡壓的癥狀、體征、診斷、治療進(jìn)行報(bào)道，在4例成人（2男、2女，年齡不計(jì)，尸體由白求恩醫(yī)學(xué)院基礎(chǔ)教研室提供）共8側(cè)雙上肢標(biāo)本上解剖觀測：肌皮神經(jīng)易卡壓點(diǎn)形態(tài)解剖學(xué)研究，肌皮神經(jīng)各肌支、入肌點(diǎn)、出肌點(diǎn)至喙突距離等。體位變化對測量長度影響。對肌皮神經(jīng)喙肱肌入肌點(diǎn)及前臂外側(cè)皮神經(jīng)肘部穿出點(diǎn)的神經(jīng)性狀及周圍腱膜組織與神經(jīng)的關(guān)系進(jìn)行觀察，并用攝像器材進(jìn)行拍攝備份。對肌皮神經(jīng)喙肱肌入肌點(diǎn)、出肌點(diǎn)不同體位變化時(shí)與喙突、胸小肌下緣的距離測量得到的數(shù)據(jù)，結(jié)果判斷：對測量指標(biāo)進(jìn)行分析、比較，證明體位變化對測量指標(biāo)的影響意義。（測量指標(biāo)越長，肌皮神經(jīng)張力越大，，易形成卡壓。證明上肢體位變化是肌皮神經(jīng)的卡壓因素其一。） 統(tǒng)計(jì)學(xué)處理：采用SPSS13.0軟件分析數(shù)據(jù)，計(jì)算資料采用x±s表示。兩組計(jì)量資料的比較采用t檢驗(yàn)。 結(jié)果:臨床病例報(bào)道證實(shí)肌皮神經(jīng)在肌皮神經(jīng)喙肱肌入肌點(diǎn)可形成卡壓，解剖觀察發(fā)現(xiàn)喙肱肌入肌點(diǎn)、前臂外側(cè)皮神經(jīng)穿出點(diǎn)易卡壓。上肢內(nèi)收、外展位時(shí)，喙肱肌入肌點(diǎn)至喙突距離分別為：（8.74±1.24）cm、（10.49±1.29）cm，距離改變差異有統(tǒng)計(jì)學(xué)意義（t=2.765，P0.05)，喙肱肌出肌點(diǎn)至喙突距離分別為：（10.74±1.23）cm、（12.52±1.32）cm，距離改變差異有統(tǒng)計(jì)學(xué)意義（t=2.786，P0.05）。 結(jié)論:通過臨床病例證實(shí)肌皮神經(jīng)喙肱肌入肌點(diǎn)可發(fā)生卡壓，肌皮神經(jīng)喙肱肌入肌點(diǎn)及前臂外側(cè)皮神經(jīng)肘前穿出點(diǎn)，這兩個部位較易有腱膜組織卡壓。上肢體位變化是肌皮神經(jīng)的卡壓因素其一。 通過對肌皮神經(jīng)易卡點(diǎn)進(jìn)行精確的解剖學(xué)研究，使我們對肌皮神經(jīng)卡壓鑒別診斷和診斷方面有了更深層的認(rèn)識；同時(shí)解剖學(xué)研究證實(shí)上肢體位變化是肌皮神經(jīng)的卡壓因素其一，我們能夠指導(dǎo)病人日常生活或體力勞動時(shí)避免因體位因素引起肌皮神經(jīng)卡壓，過度的訓(xùn)練導(dǎo)致喙肱肌肥大也能引起肌皮神經(jīng)卡壓。進(jìn)行肌皮神經(jīng)易卡點(diǎn)周圍毗鄰組織的解剖研究，能夠選擇手術(shù)的最佳入路，徹底松解卡壓的肌皮神經(jīng)，并討論注意事項(xiàng)。正中神經(jīng)與肌皮神經(jīng)之間存在著交通支，并起著一定的功能，手術(shù)時(shí)應(yīng)注意加以保護(hù)，肌皮神經(jīng)解剖變異學(xué)研究使我們不拘泥于傳統(tǒng)的解剖學(xué)，對于指導(dǎo)臨床醫(yī)學(xué)也有重要的臨床意義。
[Abstract]:Objective: to report a case of musculocutaneous nerve compression, and to study the morphology of musculocutaneous nerve by dissection of normal human body, and to obtain the anatomical changes of the compression point of musculocutaneous nerve. Methods the symptoms, signs, diagnosis and treatment of 1 case of musculocutaneous nerve entrapment were reported in 4 adults (2 males and 2 females, regardless of age). The cadavers were provided by the Department of basic Teaching and Research of Bethune Medical College. The anatomical observation of 8 upper limb specimens included: morphologic and anatomical study on the compression point of musculocutaneous nerve, the muscle branches of the musculocutaneous nerve, the point of entry, the distance from the point of muscle exit to the coracoid process, and so on. The change of posture affects the length of measurement. To observe the nerve characters of coracobrachial muscle entry point of musculocutaneous nerve and the exiting point of forearm lateral cutaneous nerve elbow and the relationship between the surrounding aponeurosis tissue and nerve. The data obtained from the distance between coracohumeral muscle entry point and coracoid process and the lower margin of pectoralis minor muscle were measured when the position of coracobrachial muscle of musculocutaneous nerve was changed. The results were as follows: the measurement index was analyzed and compared, and the influence of the position change on the measurement index was proved. The longer the measurement index, the greater the tension of musculocutaneous nerve and the easier to form compression. It is proved that the change of upper limb position is one of the factors of compression of musculocutaneous nerve. Statistical processing: SPSS 13.0 software was used to analyze the data and the calculated data were expressed as x 鹵s. T test was used to compare the measurement data between the two groups. Results: the clinical case report confirmed that the musculocutaneous nerve could be compressed at the point of entering the coracobrachial muscle of the musculocutaneous nerve. Anatomical observation showed that the coracobrachial muscle entered the muscle point, and the point of perforating the lateral cutaneous nerve of the forearm was easily compressed. The distance between coracobrachial muscle entry point and coracoid process was (8.74 鹵1.24) cm, (10.49 鹵1.29) cm, the distance between beacohumeral muscle and coracoid process was (10.74 鹵1.23) cm, (12.52 鹵1.32) cm, the distance between beacohumeral muscle and coracoid process was (10.74 鹵1.23) cm, (12.52 鹵1.32) cm. Conclusion: the clinical cases proved that the musculocutaneous nerve coracobrachial muscle entry point can be compressed, the musculocutaneous nerve coracobrachial muscle entry point and the forearm lateral cutaneous nerve elbow forward exit point, these two parts are easy to have the aponeurosis tissue compression. The change of upper limb position is one of the factors of compression of musculocutaneous nerve. Through the accurate anatomical study of the musculocutaneous nerve, we have a deeper understanding of the differential diagnosis and diagnosis of the musculocutaneous nerve entrapment, and anatomical studies have proved that the change of the upper limb position is one of the compression factors of the musculocutaneous nerve. We can guide the patient to avoid the compression of musculocutaneous nerve due to postural factors in daily life or physical labor. Excessive training can also lead to the hypertrophy of coracobrachial muscle and also to the compression of musculocutaneous nerve. The anatomical study of the adjacent tissues around the curettage point of musculocutaneous nerve can select the best approach to the operation, completely release the compressed musculocutaneous nerve, and discuss the matters needing attention. There is a communicating branch between the median nerve and the musculocutaneous nerve, which plays a certain function. The anatomical variation of the musculocutaneous nerve should be protected during the operation. It also has important clinical significance for guiding clinical medicine.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R322

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