桡神经浅支血液供应解剖学研究与神经移植的应用

Anatomic study and application in clinical nerve graft on superficial branch of radial nerve with vessel stalk

目的追踪测量供给桡神经浅支的血管起源,长度及外径等指标,为临床神经移植选材较理想的带血管蒂的神经供体提供解剖学基础。方法解剖分离68侧自愿捐献的成人上肢(局解用尸体),观察桡神经浅支的走行、血供来源等,并在手术显微镜下(放大6倍)追踪观察了供给桡神经浅支的动脉起源部位、长度以及外径等。结果桡神经浅支的血供可分为3种类型,即A型:来源于桡动脉4例;B型:来源于桡动脉、桡侧返动脉48例;C型:来源于桡动脉、桡侧返动脉、肌支动脉16例。桡神经浅支上1/3段各来源于桡动脉、桡侧返动脉、肌支动脉分别为78,108,7条,中1/3段各来源于桡动脉、桡侧返动脉、肌支动脉分别为95,3,15条,下1/3段各来源于桡动脉、桡侧返动脉、肌支动脉分别为76,0,14条。结论桡神经浅支上1/3段血供丰富,是临床上取材方便,应用理想的带血管蒂的神经移植供体。

Aim To give anatomic reference to clinical nerve graft in selecting nerve material of superficial branch of radial nerve (SRN) with vessel stalk.Methods Anotomied adult upper limbs in 68 sides and observed route,blood source of SRN, also observed blood source location, length and diameter of SRN in microscope view magnified 6 times. Results Blood source of superficial branch of radial nerve were classified into 3 types.Type A: coming from radial artery (RA). Type B: coming from RA and radial recurrent artery (RRA) Type C:coming from RA, RRA and muscular branches of radial artery. 78 branches of RA,108 branches of RRA and 7 branches of muscular branches of RA constituted superior 1/3 of superficial branch of radial nerve.95 branches of RA,3 branches of RRA and 15 branches of muscular branches of RA constituted middle 1/3,76 branches of RA,0 branches of RRA and 14 branches of muscular branches of RA constituted the lower 1/3 of superficial branch of radial nerve.Conclusion The upper 1/3 SRN is rich in blood and perfect in grafted nerve material with vessel stalk.