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  本文選題：尺神經(jīng)深筋膜瓣下前置術(shù) + 肘管綜合征�。� 參考：《山西醫(yī)科大學(xué)》2008年碩士論文

【摘要】： 目的:研究肘部尺神經(jīng)的伴行供養(yǎng)血管、尺神經(jīng)分支及肘部前內(nèi)側(cè)深筋膜血供情況,為帶血供尺神經(jīng)深筋膜瓣下前置術(shù)的可行性提供解剖學(xué)依據(jù)。 方法:取6具(男4具,女2具)成人福爾馬林防腐處理尸體12側(cè)上肢標(biāo)本,4具(男3具,女1具)成人新鮮尸體8側(cè)上肢標(biāo)本,解剖觀察肘管結(jié)構(gòu),查找并觀察肘部尺神經(jīng)分支及其血供,測量對尺神經(jīng)有供養(yǎng)作用的血管與神經(jīng)伴行長度及垂直距離。在新鮮尸體上模擬手術(shù)操作,將肘部尺神經(jīng)及其供養(yǎng)血管充分游離后進行前置,測量尺神經(jīng)可前置的最大距離。解剖肘部前內(nèi)側(cè),查找相對恒定的供養(yǎng)該處深筋膜動脈。測量工具為直尺,精度至0.1 cm。 結(jié)果:肘部尺神經(jīng)血供來源有3個:尺側(cè)上副動脈(SUCA)、尺側(cè)下副動脈(IUCA)和尺側(cè)返動脈后支(PURA),與尺神經(jīng)伴行長度分別約為15.5 cm、4.5 cm和5.5 cm。充分游離尺神經(jīng)和各供養(yǎng)動脈后,尺神經(jīng)可帶血供向前移動至少7cm。尺神經(jīng)于肘部發(fā)出關(guān)節(jié)支和肌支分別為1～3支。肘部前內(nèi)側(cè)未能發(fā)現(xiàn)恒定的供養(yǎng)該處深筋膜的動脈。 結(jié)論:行尺神經(jīng)深筋膜瓣下前置術(shù)時至少應(yīng)保留SUCA或IUCA。深筋膜瓣的制作應(yīng)依據(jù)任意皮瓣原則。
[Abstract]:Objective: to study the collateral feeding vessels, branches of ulnar nerve and anterior medial deep fascia of elbow, and to provide anatomic basis for the feasibility of subvalvular preimplantation of ulnar nerve with blood supply. Methods: 12 upper limb specimens (3 male and 1 female) were collected from 6 adult cadavers (4 males and 2 females), and the cubital tunnel structure was observed. The branches and blood supply of ulnar nerve in the elbow were observed and the degree and vertical distance of the vessels and nerves associated with the ulnar nerve were measured. The ulnar nerve of the elbow and its dependent vessels were prepositioned after the full dissociation of the ulnar nerve and its dependent vessels on the fresh cadavers. The maximum distance from which the ulnar nerve could be prepositioned was measured. Anatomize the anterior medial side of the elbow and search for a relatively constant supply of the deep fascia artery. The measuring tool is a ruler with precision up to 0.1 cm. Results: there were three sources of ulnar nerve blood supply in the elbow: superior ulnar collateral artery (SUCAA), inferior ulnar collateral artery (IUCAA) and posterior branch of recurrent ulnar artery (Pura). The accompanying length of ulnar nerve was about 15.5 cm, 4.5 cm and 5.5 cm, respectively. After fully dissociating the ulnar nerve and the feeding arteries, the ulnar nerve can move forward with blood supply at least 7 cm. The articular and muscular branches of ulnar nerve in the elbow were 1 and 3, respectively. No constant arteries supporting the deep fascia were found on the anterior medial side of the elbow. Conclusion: SUCA or IUCA should be preserved at least in the operation of ulnar nerve deep fascia flap. The manufacture of deep fascia flap should be based on the principle of arbitrary flap.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2008
【分類號】：R322;R651.3

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