摘要
目的 :为寻求解除上肢痉挛性瘫痪的新途径提供理论依据。方法 :在手术显微镜下 ,对 43侧成人上肢标本解剖观测。了解痉挛性脑瘫所致上肢痉挛性屈肘、旋前和屈腕畸形的主动肌神经肌支的来源、直径、可分离长度及发出部位。结果 :肱二头肌肌支平均 2 .72支 ,来源于肌皮神经 ( 97.5% )和正中神经 ( 2 .5% ) ;肱肌肌支平均 2 .74支 ,来源肌皮神经 ( 80 .5% ) ,其余分别来源于桡神经 ( 1 5.3% )、正中神经( 4 .2 % ) ;肱桡肌肌支平均 1 .77支 ,来源于桡神经 ;旋前圆肌肌支平均 2 .33支 ,来源于正中神经 ;尺侧腕屈肌肌支平均 1 .72支 ,来源于尺神经。它们的可分离长度分别为 :肱二头肌肌支 2 3.94mm、肱肌肌支 2 1 .6 3mm、肱桡肌肌支 2 1 .38mm、旋前圆肌肌支 2 7.2 7mm、尺侧腕屈肌肌支 2 1 .70mm。神经肌支的横径分别为 :0 .99、1 .0 0、0 .86、0 .84、0 .83mm ,在起始与进入肌门处的横径比较 (t检验 )无显著性差异 (P >0 .0 5)。结论 :神经肌支的横径考虑与神经所含数量有关 ,术中可在起始处选择性切断 ,切除的长度以术后不再出现神经再连接为度。
Objective:To provide anatomic basis for exploring a new way to treat spastic paralysis of upper extremities.Methods:Forty-three cadaveric upper extremities were dissected under operation microscope to observe the origins,amounts,lengths and diameters of the muscular branches of upper extremity nerves(MBUEN).Results:Four hundred and eighty-five muscular branches of nerves were observed,they were biceps branchii muscular branches(total,117;average,2.72)from musculocutaneous nerves(97.5%) and median nerves(2.5%),branchialis muscular branches(total,118;average,2.74)from musculocutaneous nerves(80.5%) or radialis nerves(15.3%) or median nerves (4.2%) ,brachioradialis muscular branches(total,76;average,1.77) from radalis nerves,pronator teres muscular branches(total,100;average,2.33)from median nerves and flexor carpi ulnaris muscular branches(total,74;average,1.72)from ulnar nerves.And their divided lengths were 23.94,21.63,21.38,27.27 and 21.70 mm respectiveily in turn.The transverse diameters of these branches in the origin location were 0.99,1.00,0.86,0.84,0.83 mm respectively in turn,and there was no statistical significant difference between the diameters in the origin location and entering location( P > 0.05) .Conclusion:The results show that it is possible to undertake selective partial neurectomy at the level of the muscular branches of the peripheral nerve.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2001年第3期205-207,共3页
Chinese Journal of Clinical Anatomy
关键词
脑性瘫痪
肌痉挛
神经
肌支
应用解剖
显微解剖
cerebral palsy
muscle spasticity
nerve
muscular branch
microanatomy
