人小腿骨骼肌肌内神经染色及其肌亚部划分

Staining of intramuscular nerves and muscle compartments in crus skeletal muscles of human corpse

目的:改良Sihler肌内神经染色法,对人体小腿骨骼肌进行染色,总结肌内神经分布规律并进行肌亚部划分.方法:16侧成人标本小腿的全部骨骼肌进行解剖分离,注意保留神经蒂,在此过程中进行解剖学测量.解剖分离后的肌肉用改良Sihler肌内神经染色法进行处理,最后根据研究结果对数据进行分析总结.结果:通过对Sihler染色方法在固定、除色素、溶液配制和染色过程中的4个方面的改进,染色结果更加理想;肌内神经在肌内的分布及走行规律为在起点人肌时顺肌纤维分布,在肌中部人肌时有一组肌内神经分支回返分布,当肌被肌内腱膜分成几组时神经分支也将相应分为几组;显示小腿骨骼肌可以实行亚部移植的有腓肠肌、比目鱼肌、胫骨前肌、胫骨后肌和腓骨长肌.结论:改良后的Sihler染色法对人体大块肌肌内神经有较好的显示结果,小腿骨骼肌肌内神经分布规律及其肌亚部的划分对临床医生进行肌肉移植具有重要的指导意义.

Objective:To modify the Sichler’s staining displaying the intramuscular nerve and its distribution pattern of human crus skeletal muscles,and to divide muscles into several compartments.Methods:Sixteen crus from 8 fresh adult cadavers were separated and all the muscles were dissected.After gross anatomy measurement,the specimens were stained with modified Sihler’s technique.Results:There was a better result with improvement of fix,depigmentation,solution preparation and staining.There were several patterns of nerve distribution:when nerves enter the muscle near to its origin,the nerve would run along the muscle fiber;when the nerve enter the muscle at its middle part,there was a group of branchs returning to the proximal region,and nerve branches separated into groups innervating muscle compartments separated by intramuscular tendon membranes.According to our data,the following muscles were candidates for compartment grafting:gastrocnemius,soleus,tibialis anterior,tibialis posterior and fibularis longus.Conclusion:This modified Sihler’s staining technique is useful for the research of large muscles and intramuscular nerves in human,which can provide guidance for muscle transplantation in clinic.