指尖的血管构筑

Vascular Architecture in the Fingertip

目的:为指尖离断再植提供指尖血管分布特点的形态学资料;方法:采用血管铸型、断层和显微解剖学方法对88个手指指尖血管进行了解剖观测;结果:指动脉的远侧掌横弓位于甲根平面、甲根平面以远和以近者分别占73％、19％和8％。该弓按其形态可分为均等型(62％)、优势型(31％)和交通型(7％)。弓向远侧发出外径0.3mm以上的纵行分支有6±2支,各分支经远节指骨腹侧面的指髓间隙基部向远端走行。静脉位于皮下,在甲根平面,外径0.3mm以上的静脉有7±2支,主要分布于3～5点和7～9点处,每侧甲襞内有一恒定的0.3～0.5mm的静脉。甲中平面以远已无外径达0.3mm的血管。动、静脉间存在有广泛的吻合;结论:指尖血管分布具有规律性,在甲根和甲中平面之间均易找到能满足显微吻合技术要求的血管。

Objective:To provide vascular architecture data for the replantation of severed fingertip. Method: The vascular architecture was observed and measured on 88 adult fingers with ABS vascular cast,cross-sectional and microanatomical techniques.Results:The distal transverse palmar arches(DIPA) were 73%, 19% and 8% in nail root cross section,distal and proximal nail root respectively. The DTPA had equable pattem(62%),dominance pattem(31%) and communicate pattern(7%).The lonqitudinal arteries arising from the UTPA had 6±2 branches,which exceeded 0.3mm in extemal diameter.They distribute from the base of pulp space to the ventral distal phalanx.The veins lay palmar subcutaneous.They had 7±2 branches which exceeded 0.3 mm in external diameter on cross section at the level of nail root,distributed mainly at 3-5 o'clock and 7 -90'clock.The vessels were smaller than 0.3mm in external diameter on the distal nail body. There were attentive communicating branches between the arteries and veins.Conclucsion: The veacular distribution was regular on the fingertip, and it was easy to find satisfing microvascular anastomose on the nail root and nail middle cross - section.