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对上肢浅表皮神经及其伴行血管与皮肤血供的关系进行显微解剖学研究后,设计出以上肢浅表皮神经伴行血管为蒂的岛状皮瓣。方法:新鲜成人上肢标本22侧,从肱动脉灌注红色乳胶后,对上肢浅表皮神经及伴行血管进行显微解剖。结果:(1)所有上肢皮神经都有来源于上肢知名血管的营养血管伴行。(2)与上肢浅表皮神经的伴行血管既营养神经,同时沿途又发出分支营养皮肤。(3)皮神经的伴行血管穿出深筋膜的部位有一定的规律性。结论;(1)上肢浅表皮神经的伴行血管为蒂的岛状皮瓣血供可靠,静脉回流充分,并可形成逆行蒂或顺行蒂岛状皮瓣。(2)以第2、3掌背皮神经伴行血管为蒂的岛状皮瓣,神经行走变异较多,伴行血管不稳定,临床选用时须慎重考虑。
After analyzing the relationship between the superficial epidermal nerves in the upper extremities and the blood supply of the accompanying vessels and the skin, an island flap pedicled with the superficial epicondyle nerves of the upper extremities was designed. Methods: On the 22nd side of fresh adult upper limb specimens, the superficial epidermal nerves and accompanying vessels of the upper extremities were dissected microscopically after perfusion of red latex from the brachial artery. Results: (1) All upper extremity nerves have nutrient vessels derived from well-known blood vessels of upper limbs. (2) With the superficial nerve of the upper extremity vessels vascular nerves, along with branching nutritional skin along the way. (3) The accessory nerves of the cutaneous nerve penetrate the deep fascia and have certain regularity. Conclusions: (1) The vessel flap pedicled with superficial epidermal nerve of upper extremity has reliable blood supply and venous return adequately, and can form retrograde pedicle or cistern island flap. (2) The island flap pedicled with the dorsal metacarpal and dorsal branch of the nerves 2 and 3 has more variability of nerve walking and blood vessel instability, which should be carefully considered in clinic.