【摘要】：目的 本實驗通過對掌背動脈及其皮支的起止、走行、數量、血管外徑、血供分布范圍、交通吻合情況進行解剖觀測，為臨床僅以掌背動脈遠端皮支為蒂而不必攜帶掌背動脈的掌背皮瓣的臨床應用提供解剖學依據。 方法 在20側經動脈灌注紅色天然橡膠乳漿灌注液的新鮮成人尸體手標本上，應用手術顯微鏡系統(tǒng)解剖觀測掌背動脈及其皮支的起止、走行、數量、血管外徑、血供分布范圍、交通吻合情況；觀察掌背動脈與伸肌腱的走行關系；觀察掌背動脈皮支與伸肌腱的位置毗鄰關系。 結果 掌背動脈共有4條。第1掌背動脈由橈動脈發(fā)出，示指橈背側動脈是第1掌背動脈的延續(xù)，起點外徑為0.68mm±0.12mm，末端外徑為0.42mm±0.10mm，平均長度為53.22mm±5.20mm。掌深弓近側穿支經第2、3、4掌骨間隙向背側穿出后，隨即分為上行支(亦稱近側支)和下行支(亦稱遠側支)。其上行支與腕背動脈網分支相互交通吻合，構成第2、3、4腕背吻合支。其下行支構成第2、3、4掌背動脈，于掌骨頭附近分成3條終末支：1條與指總動脈的交通支(亦稱指蹼動脈)和2條相鄰兩指相對側的指背動脈。交通支與相應的指總動脈或指固有動脈相互交通吻合，指背動脈與指固有動脈的背側支相互交通吻合，形成指背動脈網。掌背動脈與掌側動脈之間有3條交通支相連，分別位于掌骨基底(即掌背動脈起始)、掌骨頸部和近節(jié)指骨底。第2、3、4掌背動脈起點血管外徑分別為0.90mm±0.30mm、0.80mm±0.14mm、0.50mm±0.10mm，末端血管外徑分別為0.60mm±0.20mm、0.38mm±0.12mm、0.40mm±0.12mm，平均長度分別為56.80mm±8.20mm、52.20m±5.40mm、40.00mm±8.22mm。各掌背動脈在行程中發(fā)出7～12條皮支營養(yǎng)手背部的皮膚；發(fā)出2～5條肌腱支呈弓狀走行于伸肌腱周組織內，階段性營養(yǎng)伸肌腱；發(fā)出2～4條骨膜支營養(yǎng)骨膜
[Abstract]:Objective to observe the origin, movement, number, diameter, distribution of blood supply and anastomosis of the dorsal metacarpal artery and its cutaneous branches. To provide anatomic basis for clinical application of dorsal metacarpal flap pedicled only with the cutaneous branch of dorsal metacarpal artery without carrying dorsal metacarpal artery. Methods 20 fresh adult cadavers with transarterial infusion of red natural rubber emulsion were used to observe the onset and termination of dorsal metacarpal artery and its cutaneous branches, the number, the diameter of blood vessel and the distribution range of blood supply. Traffic anastomosis; The relationship between dorsal metacarpal artery and extensor tendon and the position of cutaneous branch and extensor tendon of dorsal metacarpal artery were observed. Results there were 4 dorsal palmar arteries. The first dorsal metacarpal artery came from the radial artery, indicating that the dorsal radial artery of the finger was a continuation of the first dorsal metacarpal artery. The external diameter of the first dorsal metacarpal artery was 0.68mm 鹵0.12 mm, the outer diameter of the end was 0.42mm 鹵0.10 mm, and the average length was 53.22mm 鹵5.20 mm. The proximal perforating branch of deep metacarpal arch was divided into ascending branch (proximal branch) and descending branch (distal branch) immediately after perforating to the dorsal side of metacarpal space. The ascending branch anastomosed with the branches of the dorsal carpal artery network. The descending branch of the artery consists of the 4th dorsal metacarpal artery, which is divided into three terminal branches near the metacarpal bone: one communicating branch of the common digital artery (also known as the webbed artery) and two dorsal digital arteries adjacent to the opposite side of the two fingers. The communicating branches were anastomosed with the corresponding common digital artery or digital artery, and the dorsal digital artery was anastomosed with the dorsal branch of the digital artery to form a network of dorsal digital arteries. There are three communicating branches between dorsal palmar artery and palmar artery, which are located at the base of metacarpal bone (starting of dorsal metacarpal artery), neck of metacarpal bone and the base of proximal phalangeal bone. The external diameters of the starting vessels of the dorsal metacarpal artery were 0.90mm 鹵0.30mm, 0.80mm 鹵0.14mm, 0.50mm 鹵0.10mm, 0.60mm 鹵0.20mm, 0.38mm 鹵0.12mm and 0.40mm 鹵0.12mm, respectively. The average length of the vessels was 56.80mm 鹵8.20mm. 52.20m 鹵5.40mm, 40.00mm 鹵8.22mm. Each dorsal metacarpal artery gave off 712 cutaneous branches to nourish the skin of the back of the hand; 2 tendinous branches were issued arcuate through the tissues around the extensor tendons, and 2 periosteal branches were issued to nourish the periosteum.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2006
【分類號】：R322

【引證文獻】

相關期刊論文 前1條

1 鄧雪峰;周麗英;陳杰明;黃定根;;掌背U-Ⅰ型血管蒂筋膜瓣在手指中遠節(jié)軟組織缺損的應用[J];中國現代手術學雜志;2010年05期

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本文編號：2367505