带桡神经浅支及其营养血管筋膜皮瓣的应用解剖

APPLIED ANATOMY OF THE FASCIOCUTANEOUS FLAP PEDICLED SUPERFICIAL BRANCH OF RADIAL NERVE AND ITS NUTRIENT VESSELS

目的:为带桡神经浅支及其营养血管筋膜皮瓣的临床应用提供形态学基础.方法:在32例成人上肢标本上,观测了桡神经浅支浅段及其营养血管、以及该血管与筋膜皮肤的供血关系.结果:桡神经浅交浅段的血供主要来自桡动脉的肌皮支或皮支,其中以桡动脉显露段的粗大皮支,鼻咽壶段的茎突返支及虎口区的皮动脉较为恒定,起点外径分别为0.8mm、0.7mm及0.6mm:穿出深筋膜前长分别为0.8cm、1.1cm及0.5cm.皮动脉的神经支在神经旁或神经干内相互沟通形成纵向链状血管网,并借吻合支与皮动脉筋膜皮支构成的皮下血管网、筋膜血管网等连接.结论:可设计成带桡神经浅支及其营养血管的顺行或逆行筋膜皮瓣,转位修复邻近部位的软组织缺损.

To provide anatomic basis for the apply of fasciocutaneous flap based on superficial branch of radial nerve and its nutrient vessels. Methods: The observation and measurement of superficial segment of the superficial branch of radial nerve and its nutrient vessels and the blood supplies of its adjacent skin were made on 32 adult cadaver upper limbs specimens. Results:The blood supply of superficial segment of superficial branch of radial nerve origins mainly from the myocutaneous and cutaneous vessels of which the large cutaneous artery of exposed segment of radial artery, retrograde cutaneous artery of styloid process of snuff-box segment and cutaneous artery in kite whose diameters are respectively 0.8mm,0.7mm and 0.6mm at their point of origin and lengths before perforated from the deep fascia are 0. 8cm, 1.1cm and 0. 5cm, are more constant. A longitudinal anastomosis (chain-linked system) of the interneural fascicle and paranerves was formed by these neutrient vessels of superficial branch of the radial nerve and a broad artery network in superficial fascia around the cutaneous nerves also anastomosed by the cutaneous artery and the neural neutrient ones each other. Conclusions:The direct or recurrent fasciocutaneous flap of the superficial branch of radial nerve and its nutrient vessels could be designed and used to repair the soft tissue defects of the adjacent sites.