隐神经移植的应用解剖

Applied anatomy of saphenous nerve graft

目的 为自体隐神经移植提供解剖学基础。方法 15具成人尸体 ,男性 12具 ,女性 3具 ,共 30侧下肢。经股动脉灌注氨水稀释的红色乳胶后进行大体解剖和观测。结果 隐神经双干型占 46 .7% (14/30 ) ,浅出点横径 0 .2 8± 0 .0 3cm ,可游离长度 8.42± 4.5 8cm ,距体表深度 1.19± 0 .44cm ;前外支横径 0 .14± 0 .0 3cm ,可游离长度 18.81± 4.5 0cm ;后内支横径 0 .14± 0 .0 4cm ,可游离长度 19.32± 3.0 4cm。单干型占 5 3.3% (16 /30 ) ,浅出点横径 0 .2 5± 0 .0 6cm ,可游离长度 2 9.94± 3.34cm ,距体表深度同双干型。隐神经小动脉丰富 ,其上段小动脉直径≥ 1mm者 2 9条 (2 3% )。下段小动脉少而细 ,寻找隐神经 ,有两个可靠的手术部位。结论 隐神经是较理想的微血管吻合的移植供体 。

Objective To provide anatomic basis for autologous saphenous nerve graft.Methods The red latex diluted by ammonia water were injected through femoral artery in 15 adult cadavers(12male and 3 female), and their 30 lower extremities were observed and measured.Results The type of bitrunks of saphenous nerve accounted for 46.7%(14/30),and transverse diameter of superficial site of them was 0.28±0.03?cm,the freed length was 8.43±4.58?cm,and the depth to the surface of the body was 1.19±0.44?cm.The transverse diameter of anterior lateral branch was 0.14±0.03?cm,it's freed length was 18.81±4.50?cm.The transverse diameter of the posterior branch was 0.14±0.04?cm,and it's freed length was 19.32±3.04?cm.The type of single trunk accounted for 53.3%(16/30),it's diameter was 0.25±0.06?cm ,freed length 29.94±3.34?cm,and the depth to the surface of the body was as the bitrunks type. There was so many small arteries entering the upper part of the saphenous nerve .It's small arteries (diameter≥1mm) accounted for 23% (total 29) in upper part, but less and thinner in the lower part of the nerve . There were two reliable place for harvesting the nerve.Conclusion Saphenous nerve is a good donor for microvascular anastomosis in nerve graft and may be harvested from two reliable places.