带血管轴隐神经的应用解剖

APPLIED ANATOMY OF SAPHENOUS NERVE WITH VASCULAR AXIS

目的：为临床应用带血管的隐神经提供解剖学依据。方法：用乳胶灌注成人尸体32侧下肢并解剖，对隐神经及血管进行观测。结果：隐神经自穿出深筋膜处至内踝最突点的全长为（34．2±3．2）cm，宽度为（3．2±0．8）cm。隐神经的上都由隐动脉营养，其穿出深筋膜处外径是（1．3±0．3）mm，中、下1／3都由4～6条焊后动脉的肌间隔穿支及附内侧动脉管养，它们的外径均超过1．0mm。营养隐神经的血管轴与胫后动脉及足背动脉发出的穿交互相吻合。隐神经在穿深筋膜处及小腿下1／3区，位于大隐静脉的后方。结论：隐动脉及胜后动脉的肌间隔穿支可分别作为带血管的轴型和岛状隐神经皮瓣的轴心动脉。大隐静脉的行径可作为寻找隐神经的标志。

Objective:To provide anatomic basis for clinical application of saphenous nerve with vasculari-ty. Method: The saphenous nerve and its blood vessels were measured in 32 side adult cadaver legs in-jected with emulsion. Rcsults: The width of cross section of the saphenous nerve at its emergence is (3. 2±0. 8)cm. The length of the superficial part of nerve stem is (34. 2±3. 2)cm. The saphenous artery sup-plies the upper part of nerve .and the outer diameter of the saphenous artery at its origin is (1. 3±0. 3)mm. The middle and lower parts of the saphenous nerve are nourished by 4-6 intermuscular septum per-forating branches of the posterior tibial artery and medial tarsal artery,and the average outer diameters of these arteries are larger than 1.0mm. Vascular axis of the saphenous nerve anastomosed with the per-forators issuing from the posterlor tibial artery and medial tarsal artery. The saphenous nerve is posteri-or to great saphenous vein in perforating deep fascia and the distal one third of the leg. Conclusion: The saphenous artery and intermuscular septum perforating branches of the posterior tiblal artery are the ar-terial axis of the axial-pattern flap and island neuroskin flap (saphenous nerve )respectively. The course of the great saphenous vein is a mark for seeking saphenous nerve.