【摘要】： 背景：1908年Hunt首先描述了腕部尺神經(jīng)卡壓綜合癥(ulnar tunnel sydrome，UTS)，亦稱(chēng)之為腕尺管綜合癥，是尺神經(jīng)在腕部?jī)?nèi)受到各種因素的卡壓而出現(xiàn)的一組癥狀和體癥。UTS臨床上較少見(jiàn)，病因較多，臨床癥狀和體征多樣，可伴有其它疾病，使診斷更加困難，相關(guān)文獻(xiàn)國(guó)外報(bào)道較多，國(guó)內(nèi)報(bào)道較少。國(guó)內(nèi)外學(xué)者不斷對(duì)其進(jìn)行研究，相繼有一些新進(jìn)展報(bào)道，有關(guān)手部尺神經(jīng)和小魚(yú)際肌的解剖關(guān)系國(guó)外報(bào)道較多，國(guó)內(nèi)尚沒(méi)有這方面的文獻(xiàn)報(bào)道。國(guó)內(nèi)學(xué)者對(duì)尺神經(jīng)深支的走行、毗鄰、分支、分布、體表投影，進(jìn)行了觀測(cè)。腕尺管區(qū)解剖結(jié)構(gòu)復(fù)雜，有待于進(jìn)一部研究，提供國(guó)人的解剖學(xué)數(shù)據(jù)。 目的：研究腕尺管內(nèi)不同平面管徑的大小，血管、神經(jīng)的大小及其伴行關(guān)系，進(jìn)一步探討腕尺管內(nèi)神經(jīng)的卡壓因素，研究小魚(yú)際肌變異及手部尺神經(jīng)樹(shù)枝狀模式，觀察小魚(yú)際肌和尺神經(jīng)的關(guān)系。 方法：我們對(duì)30個(gè)防腐尸體手(延邊大學(xué)解剖學(xué)與組織胚胎學(xué)教研部提供)進(jìn)行了解剖學(xué)研究，通過(guò)4倍放大鏡下解剖手的尺側(cè)，記錄腕尺管內(nèi)不同平面管徑的大小，血管、神經(jīng)的大小，小魚(yú)際肌肌腹的數(shù)量和它們的變異，尺神經(jīng)深支裂隙處小魚(yú)肌腱弓的組成模式，尺神經(jīng)在每一個(gè)手的分支。觀察小魚(yú)際肌的變異和樹(shù)枝狀尺神經(jīng)之間的關(guān)系。 結(jié)果：腕尺管管徑入口處窄而高，小魚(yú)際腱弓下間隙的寬度大于血管神經(jīng)束的橫徑，而縱向高度與血管神經(jīng)束的縱徑幾乎相等，小指展肌在4個(gè)手有一個(gè)肌腹，在25個(gè)手有2個(gè)肌腹，在1個(gè)手有3個(gè)肌腹。小指短屈肌在4個(gè)手缺如，在22個(gè)手有一個(gè)肌腹，在4個(gè)手有2個(gè)肌腹。在所有小指對(duì)掌肌部有兩層，尺神經(jīng)深支通過(guò)兩層之間，我們觀察有3種尺神經(jīng)深支的裂隙模式，5種尺神經(jīng)樹(shù)枝狀分布模式，根據(jù)解剖形態(tài)特點(diǎn)我們把小指展肌的運(yùn)動(dòng)神經(jīng)支配模式分為4種類(lèi)型。發(fā)現(xiàn)3個(gè)手的尺神經(jīng)深支起點(diǎn)有變異，起自于從尺神經(jīng)遠(yuǎn)端到分支處。三個(gè)手的兩個(gè)感覺(jué)支之間有一個(gè)交通支。發(fā)現(xiàn)兩個(gè)手的尺側(cè)感覺(jué)支有分支進(jìn)入小指展肌。 結(jié)論：我們總結(jié)了尺神經(jīng)和小魚(yú)際肌之間的解剖關(guān)系，，證明它們之間的關(guān)系是非常復(fù)雜的，這些解剖知識(shí)可以為腕尺管綜合征的診斷和治療提供解剖學(xué)依據(jù)。
[Abstract]:Background: Hunt first described ulnar nerve entrapment syndrome (ulnar tunnel sydrome,UTS) in 1908, also known as ulnar tunnel syndrome. There are many clinical symptoms and signs, which can be accompanied by other diseases, which make diagnosis more difficult. Scholars at home and abroad continue to study it, and there have been some new progress reports. There are many reports on the anatomical relationship between the ulnar nerve of hand and the hypothenar muscles, but there are no reports on this aspect in our country. Domestic scholars have observed the walking, adjacent, branching, distribution and surface projection of the deep branch of ulnar nerve. The anatomical structure of the ulnar carpal canal is complex, which needs to be studied to provide Chinese anatomical data. Objective: to study the size of different plane diameters, blood vessels and nerves in the ulnar carpal canal, and the relationship between them, and to study the factors of entrapment of the nerve in the ulnar carpal tunnel, the variation of the hypothenar muscle and the tree-like pattern of ulnar nerve in the hand. To observe the relationship between hypothenar muscle and ulnar nerve. Methods: we studied the anatomy of 30 embalmed cadaveric hands (provided by Department of Anatomy and Embryology, Yanbian University). The ulnar side of the hand was dissected under 4 times magnifying glass, and the sizes and vessels of the different plane diameters in the ulnar carpal canal were recorded. The size of the nerves, the number of hypothenar muscles and their variations, the pattern of the tendinous arch in the fissure of the deep branch of the ulnar nerve, the branch of the ulnar nerve in each hand. To observe the relationship between the variation of hypothenar muscle and the branch ulnar nerve. Results: the diameter of the ulnar canal was narrow and high. The width of the space under the hypothenar tendon arch was larger than the transverse diameter of the vascular nerve bundle, but the longitudinal height was almost equal to the longitudinal diameter of the vascular nerve bundle. There are 2 muscles in 25 hands and 3 in 1 hand. The flexor brevis was absent in 4 hands, one in 22 hands and two in 4 hands. There are two layers in all the palmar muscles of the lesser finger, and the deep branch of ulnar nerve passes between the two layers. We observe three fracture patterns of the deep branch of the ulnar nerve and five kinds of branches of the ulnar nerve. According to the anatomical features, we divided the motor innervation pattern of abductor muscle into four types. The origin of the deep branch of ulnar nerve in 3 hands was found to vary from the distal part of ulnar nerve to the branch. There is a traffic branch between the two sensory branches of the three hands. Branches of the ulnar sensory branches of both hands were found to enter the abductor muscle of the lesser finger. Conclusion: we summarize the anatomical relationship between ulnar nerve and hypothenar muscle and prove that the relationship between ulnar nerve and hypothenar muscle is very complicated. These anatomical knowledge can provide anatomic basis for diagnosis and treatment of ulnar carpal tunnel syndrome.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類(lèi)號(hào)】：R322

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