發(fā)布時(shí)間：2018-02-11 22:43

  本文關(guān)鍵詞： 臂叢 副神經(jīng) 神經(jīng)移位 解剖學(xué)研究　出處：《廣西醫(yī)科大學(xué)》2007年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的:對(duì)斜方肌內(nèi)的神經(jīng)支配進(jìn)行解剖學(xué)研究,為尋找副神經(jīng)移位到肩胛上神經(jīng)的最佳移位點(diǎn)和移位方式提供解剖依據(jù)。 方法:選用成人尸體標(biāo)本10具20側(cè),觀察斜方肌的神經(jīng)支配,觀察副神經(jīng)在斜方肌內(nèi)的行徑及分支。并切取副神經(jīng)、肩胛上神經(jīng)做不同水平橫斷面病理切片,計(jì)數(shù)各神經(jīng)斷面的神經(jīng)纖維數(shù),并進(jìn)行比較。 結(jié)果:副神經(jīng)在鎖骨上2-3cm進(jìn)入斜方肌,在深面筋膜內(nèi)斜向后走行。在肩胛岡中點(diǎn)前上方3—4cm處,有來(lái)自頸叢的交通支加入后形成終末支,然后越過(guò)肩胛岡內(nèi)側(cè)端直線向下走行至斜方肌下部。副神經(jīng)在頸叢交通支匯入前發(fā)出2-4支較大的肌支支配斜方肌上部,匯入后沿途發(fā)出4—7個(gè)小分支支配斜方肌下部肌肉。副神經(jīng)的神經(jīng)纖維計(jì)數(shù):副神經(jīng)入肌點(diǎn)處(A點(diǎn))為1245±46條,頸叢的交通支匯入前B點(diǎn)為830±36條,后路手術(shù)切斷點(diǎn)C為1074±38條。 結(jié)論:后進(jìn)路副神經(jīng)移位術(shù)解剖恒定,操作簡(jiǎn)單,該術(shù)式不影響斜方肌上部神經(jīng)支配,充分利用了頸叢交通支,且縮短了神經(jīng)再生距離,值得推廣。與頸叢交通支合干后,副神經(jīng)在H-G段分支少,因此損失的神經(jīng)纖維數(shù)少,故H-G段是副神經(jīng)的最佳移位點(diǎn)。
[Abstract]:Objective: to study the innervation of trapezius muscle and provide anatomic basis for finding the best point and mode of transposition of accessory nerve to suprascapular nerve. Methods: the nerve innervation of trapezius muscle was observed on 20 sides of 10 cadavers of adult cadavers, and the behavior and branch of accessory nerve in trapezius muscle were observed. The number of nerve fibers in each nerve section was counted and compared. Results: the accessory nerve entered the trapezius muscle 2-3 cm above the clavicle and ran diagonally backward in the deep gluten. At the point 3 to 4 cm above the midpoint of scapula, a branch of communication from the cervical plexus was added to form the final branch. Then straight down across the medial end of the scapula to the lower part of the trapezius. The accessory nerve emits 2-4 larger muscle branches to the upper part of the trapezius before the communicating branches of the cervical plexus converge. The number of nerve fibers in the accessory nerve was 1245 鹵46, 830 鹵36, and 1074 鹵38, respectively, and the number of nerve fibers in the accessory nerve was 1245 鹵46, 830 鹵36, and 1074 鹵38 respectively. Conclusion: the posterior approach of accessory nerve transposition is stable in anatomy and simple in operation. It does not affect the superior trapezius nerve innervation, makes full use of the communicating branch of the cervical plexus, and shortens the nerve regeneration distance, so it is worth popularizing. The number of nerve fibers lost in H-G segment is less than that in H-G segment, so H-G segment is the best transposition point of accessory nerve.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R322;R651.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 丁旭明,陳德松;肱三頭肌長(zhǎng)頭移位重建肩外展功能[J];骨與關(guān)節(jié)損傷雜志;2003年09期

2 陳亮,顧玉東;分娩性臂叢神經(jīng)損傷的診治[J];國(guó)外醫(yī)學(xué).骨科學(xué)分冊(cè);2003年05期

3 官士兵;侯春林;陳德松;顧玉東;;后入路副神經(jīng)移位修復(fù)肩胛上神經(jīng)術(shù)式的臨床應(yīng)用研究[J];科技導(dǎo)報(bào);2006年06期

4 吳煜農(nóng),邱蔚六,張志愿,張陳平,王布鐳;斜方肌神經(jīng)支配的解剖學(xué)研究[J];口腔醫(yī)學(xué);1999年03期

5 侯春林;張文明;包聚良;徐印坎;;胸大肌上半部翻轉(zhuǎn)移位代三角肌術(shù)[J];上海醫(yī)學(xué);1985年12期

6 張咸中,金春;患側(cè)頸_7神經(jīng)根移位治療產(chǎn)癱根性撕脫傷[J];實(shí)用手外科雜志;2003年04期

7 王樹(shù)鋒,張高孟,顧玉東,張麗銀,趙新;鎖骨下水平副神經(jīng)切斷移位修復(fù)肩胛上神經(jīng)的臨床觀察[J];中華骨科雜志;2000年10期

8 勞杰,熊良儉,顧玉東,張高孟,趙新;斜方肌神經(jīng)支配的應(yīng)用解剖學(xué)研究[J];中華手外科雜志;1999年03期

9 蔡佩琴,顧玉東,薛鋒,彭峰,陳琳;同側(cè)頸_7神經(jīng)根移位術(shù)的臨床應(yīng)用[J];中華手外科雜志;2002年02期

10 官士兵,陳德松,方有生,蔡佩琴,陳琳,彭峰,顧玉東;后進(jìn)路副神經(jīng)移位修復(fù)肩胛上神經(jīng)術(shù)式的解剖學(xué)研究[J];中華手外科雜志;2004年01期

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