指掌侧静脉的解剖学研究及临床意义

Applied anatomy and clinical significance of palmar digital veins

目的 :探讨指掌侧固有静脉是否存在 ,指掌侧浅、深静脉在断指再植中的应用价值。方法 :5只新鲜尸体手 ,以环氧树脂混合溶液为填充剂 ,灌注后制成动、静脉分色手血管铸型标本 ,在手术显微镜下解剖观测。结果 :指掌侧固有静脉分布不恒定 ,在示、中、环指共 30条手指血管神经束中发现 3条 ,指掌侧固有静脉起自手指中节 ,在血管束内伴随指动脉而行 ,在指根部注入指掌侧总静脉 ,在手指近节其外径为(0 .2 1± 0 .0 3)mm。指掌侧浅静脉位置恒定 ,在远侧指间关节处汇聚成 2～ 4条较粗大的纵向静脉干 ,逐渐向指掌侧中线的两侧分布 ,形成 2条静脉主干 ,其在中节的外径为 (0 .6 4± 0 .12 )mm ,在近节的外径为 (0 .78± 0 .10 )mm。指掌侧浅静脉管径较粗 ,但细于指背静脉 ,其与指背静脉外径的差异有非常显著意义 (P <0 .0 1)。结论 :指掌侧固有静脉不恒定 ,属于一种退化现象 ,不能作为断指再植中的常规吻合静脉。指背静脉是断指再植中的主要吻合静脉 ,指掌侧浅静脉具有吻合价值。在断指再植中吻合指背静脉的同时 ,吻合指掌侧浅静脉利于再植指的静脉回流 ,提高断指再植的成活率。

Objective: To study the anatomy of palmar digital veins and evaluate its clinical significance.Methods: Microanatomical observation and measure of palmar digital veins were performed on 5 fresh adult hand specimens after colophony perfusion.Results: 3 proper palmar digital veins were found in the 30 digital nerves and vessels.They were very tiny with outer diameters of 0.21±0.03 mm. Superficial palmar digital veins are larger, with outer diameters of 0.78±0.10 mm, thus have clinical value for anastomosis.Conclusion: The proper palmar digital vein do exist, but it can not be anatomosed for transplantation, while the superficial palmar digital vein can be anatomosed for transplantation.