后路副神經(jīng)移位術重建肩外展功能的解剖學研究
本文關鍵詞: 臂叢 副神經(jīng) 神經(jīng)移位 解剖學研究 出處:《廣西醫(yī)科大學》2007年碩士論文 論文類型:學位論文
【摘要】: 目的:對斜方肌內(nèi)的神經(jīng)支配進行解剖學研究,為尋找副神經(jīng)移位到肩胛上神經(jīng)的最佳移位點和移位方式提供解剖依據(jù)。 方法:選用成人尸體標本10具20側,觀察斜方肌的神經(jīng)支配,觀察副神經(jīng)在斜方肌內(nèi)的行徑及分支。并切取副神經(jīng)、肩胛上神經(jīng)做不同水平橫斷面病理切片,計數(shù)各神經(jīng)斷面的神經(jīng)纖維數(shù),并進行比較。 結果:副神經(jīng)在鎖骨上2-3cm進入斜方肌,在深面筋膜內(nèi)斜向后走行。在肩胛岡中點前上方3—4cm處,有來自頸叢的交通支加入后形成終末支,然后越過肩胛岡內(nèi)側端直線向下走行至斜方肌下部。副神經(jīng)在頸叢交通支匯入前發(fā)出2-4支較大的肌支支配斜方肌上部,匯入后沿途發(fā)出4—7個小分支支配斜方肌下部肌肉。副神經(jīng)的神經(jīng)纖維計數(shù):副神經(jīng)入肌點處(A點)為1245±46條,頸叢的交通支匯入前B點為830±36條,后路手術切斷點C為1074±38條。 結論:后進路副神經(jīng)移位術解剖恒定,操作簡單,該術式不影響斜方肌上部神經(jīng)支配,充分利用了頸叢交通支,且縮短了神經(jīng)再生距離,值得推廣。與頸叢交通支合干后,副神經(jīng)在H-G段分支少,因此損失的神經(jīng)纖維數(shù)少,故H-G段是副神經(jīng)的最佳移位點。
[Abstract]:Objective: to study the innervation of trapezius muscle and provide anatomic basis for finding the best point and mode of transposition of accessory nerve to suprascapular nerve. Methods: the nerve innervation of trapezius muscle was observed on 20 sides of 10 cadavers of adult cadavers, and the behavior and branch of accessory nerve in trapezius muscle were observed. The number of nerve fibers in each nerve section was counted and compared. Results: the accessory nerve entered the trapezius muscle 2-3 cm above the clavicle and ran diagonally backward in the deep gluten. At the point 3 to 4 cm above the midpoint of scapula, a branch of communication from the cervical plexus was added to form the final branch. Then straight down across the medial end of the scapula to the lower part of the trapezius. The accessory nerve emits 2-4 larger muscle branches to the upper part of the trapezius before the communicating branches of the cervical plexus converge. The number of nerve fibers in the accessory nerve was 1245 鹵46, 830 鹵36, and 1074 鹵38, respectively, and the number of nerve fibers in the accessory nerve was 1245 鹵46, 830 鹵36, and 1074 鹵38 respectively. Conclusion: the posterior approach of accessory nerve transposition is stable in anatomy and simple in operation. It does not affect the superior trapezius nerve innervation, makes full use of the communicating branch of the cervical plexus, and shortens the nerve regeneration distance, so it is worth popularizing. The number of nerve fibers lost in H-G segment is less than that in H-G segment, so H-G segment is the best transposition point of accessory nerve.
【學位授予單位】:廣西醫(yī)科大學
【學位級別】:碩士
【學位授予年份】:2007
【分類號】:R322;R651.3
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