以皮神经及营养血管为蒂臂内侧皮瓣的应用解剖

Applied anatomy of medial arm flap pedicled with cutaneous nerve and nntrient vessel

目的：为带臂内侧皮神经及其营养血管筋膜皮瓣提供形态学基础。方法：在３２侧成人上肢标本上，观测臂内侧皮神经营养血管及其周围皮肤的供血情况。结果：臂内侧皮神经的血供来自尺侧上副动脉肌间隔皮支、肱动脉肌间隔皮支和尺侧下副动脉肌间隔皮支，起始处外径分别为１．０ｍｍ、０．６ｍｍ和０．７ ｍｍ，穿出深筋膜前长为 １．５ ｃｍ、１． １ｃｍ和 １．２ ｃｍ。其神经支在神经束间或神经旁相互吻合构成丰富的血管网，并借分支与筋膜皮支所形成的皮下筋膜血管网沟通。结论：以臂内侧度神经及其营养血管为蒂可形成臂内侧筋膜皮瓣，顺行或逆行转位修复邻近部位的软组织缺损。

To provide morphologic basis for the medial arm fascial cutaneous flap. Methods: Blood supply of medial arm cutaneous nerve and its adjacent skin were observed on 32 sides of adults arm specimens. Results: The blood supply of medial arm cutaneous nerves origined from three cutaneous branch of intermuscular sepia, which from superior ulnar collateral artery, brachial artery and inferior ulnar collateral artery. The mean diameters at the originated site were 1 .0 mm, 0.6 mm and 0.7 mm.The length of the branches were 1.5 cm, 1. 1 cm and 1 .2 cm separately before they perforating the deep fascia.They anastomoses with nerve blanch which formed rich vessel network among nerve tract or beside the nerve. Conclusion:The medial arm fascial cutaneous flap pedicled with cutaneous and nutrient vessel could be directly or adversely transfered to repair adjacent soft tissue defect.