同种异体带血供肱骨移植的解剖学研究

Anatomic study of allogeneic vascular humeral transplantation

目的 :为吻合血管同种异体肱骨移植提供解剖学依据。方法 :在 40侧经动脉灌注红色乳胶的成人上肢标本上 ,着重观测肱骨上端及肱骨干滋养血管和骨膜血管的来源、分布、长度和外径 ;5 0根干燥成人肱骨 ,观察肱骨上端及肱骨干的滋养孔。结果 :肱骨上端外科颈周围平均有 (7.7± 2 .0 )个 (4～ 12个 )滋养孔 ,滋养支来自旋肱前动脉和旋肱后动脉。肱骨干滋养孔 1～ 3个 ,主要位于肱骨中段前内侧面 ,距内上踝 (11.7± 2 .2 )cm(6 .5～ 17.0cm)。滋养动脉主要来自肱动脉 ,长 (2 .6± 0 .7)cm(1.5～ 5 .0cm) ,外径(1.3± 0 .6 )mm(0 .8～ 2 .2mm)。结论 :选用旋肱前血管为蒂 ,可行肱骨上段移植 ,选用肱血管和肱深血管为蒂 ,可作肱骨中段移植。

Objective: To provide anatomical basis for allogeneic vascular humeral transplantation. Methods: The origins,distributions,lengths and calibers of nutrient vessels of the humeri and their superior epiphysis were observed on 40 sides of adult cadaveric specimens,which were injected with red latex in arteries.The nutrient foramen of the humeri and their superior epiphysis were observed on 50 sides of adult dry bones.Results:There were 7.7±2.0(4～12) nutrient foramens around surgical neck on the superior epiphysis of humerus,the nutrient vessels originated from the anterior circumflex humeral artery and posterior circumflex humeral artery.There were 1～3 nutrient foramens on the anterior internal of humeral median,it was (11.7±2.2) cm(6.5～17.0 cm) from these foramens to medial epicondyle,and these nutrient arteries originated from humeral arteries,their length was (2.6±0.7) cm(1.5～5.0 cm) and their diameter was (1.3±0.6) mm(0.8～2.2 mm).Conclusions:The superior epiphysis of humerus can graft with anterior circumflex humeral vessel,the humeral diaphysis can graft with deep humeral vessel,the humeral nutrient vessel in case of necessity choice.