發(fā)布時(shí)間：2018-02-15 13:04

  本文關(guān)鍵詞： 豌豆骨 腕骨 壞死 移植 解剖學(xué)　出處：《山東大學(xué)》2006年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的：觀察豌豆骨的血供來(lái)源和滋養(yǎng)動(dòng)脈的分布特點(diǎn)，并測(cè)量各滋養(yǎng)動(dòng)脈的管徑和長(zhǎng)度，為以帶血管蒂豌豆骨轉(zhuǎn)移替代其他腕骨壞死提供解剖學(xué)依據(jù)。 方法：1．解剖20側(cè)新鮮紅色乳膠灌注的成人上肢標(biāo)本，結(jié)合局部鑄型標(biāo)本，觀察豌豆骨的血供來(lái)源及血供分布特點(diǎn)。 2．精確測(cè)量豌豆骨主要滋養(yǎng)血管的管徑和長(zhǎng)度，并對(duì)所測(cè)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果：1．豌豆骨的血供來(lái)源 豌豆骨的滋養(yǎng)動(dòng)脈主要來(lái)自尺動(dòng)脈、尺動(dòng)脈腕上皮支下行支和尺動(dòng)脈掌深支，其周?chē)�附著的肌肉、肌腱及韌帶的營(yíng)養(yǎng)血管也直接或間接地營(yíng)養(yǎng)該骨。 2．豌豆骨周?chē)�血供分布特點(diǎn) 豌豆骨除背側(cè)與三角骨形成的關(guān)節(jié)面沒(méi)有血供分布，其近、遠(yuǎn)、尺、橈側(cè)均有血供分布。尺動(dòng)脈1～3條直接小分支自橈側(cè)入骨；尺動(dòng)脈腕上皮支下行支的豌豆骨支自尺側(cè)和近端入骨；尺動(dòng)脈掌深支的返支(出現(xiàn)率80％)沿豆-鉤韌帶尺側(cè)至該骨尺側(cè)和遠(yuǎn)端入骨。另外，附著在豌豆骨近端的尺側(cè)腕屈肌腱，遠(yuǎn)端的小指展肌，以及周?chē)�的腕橫韌帶、豆鉤韌帶、豆掌韌帶及尺側(cè)副韌帶等，這些組織的血管也直接或間接地營(yíng)養(yǎng)該骨。 3．豌豆骨的各滋養(yǎng)動(dòng)脈及其分支分別沿豆—三角關(guān)節(jié)囊和在豌豆骨周?chē)�形成�?nèi)、外兩個(gè)動(dòng)脈環(huán)。 4．豌豆骨主要滋養(yǎng)血管的管徑和長(zhǎng)度 (1)尺動(dòng)脈腕上皮支自豌豆骨近端以上41.502±5.247mm處從尺動(dòng)脈的內(nèi)側(cè)發(fā)出，起始段外徑1.443±0.070mm。尺動(dòng)脈腕上皮支又分為上行支與下行支，其下行支起始部外徑1.232±0.080mm，發(fā)出豌豆骨支分布至豌豆骨尺側(cè)和近端。以尺動(dòng)脈腕上皮支下行支為蒂轉(zhuǎn)移豌豆骨，血管蒂長(zhǎng)度為50.057±
[Abstract]:Objective: to observe the origin of blood supply of pea bone and the distribution of nutrient artery, and to measure the diameter and length of each nutrient artery so as to provide anatomic basis for replacing other carpal osteonecrosis with vascularized pea bone metastasis. Methods: 1. Dissected 20 fresh red latex perfused adult upper limb specimens and observed the blood supply source and blood distribution characteristics of pea bone combined with local cast specimen. 2. The diameter and length of the main nourishing vessels of the pea bone were measured accurately, and the data were analyzed statistically. Results 1. The blood supply of the pea bone came mainly from the ulnar artery, the descending branch of the superior cutaneous branch of the ulnar artery and the deep metacarpal branch of the ulnar artery. The muscles, tendons and ligaments attached thereto also directly or indirectly nourished the bone. 2. Distribution of blood supply around the pea bone; there was no blood supply distribution on the articular surface of the pea bone except the dorsal side and the triangular bone, and there was blood supply distribution in the proximal, distal, ulnar and radial sides. The pea bone branch of the descending branch of the superior cutaneous branch of the ulnar artery enters the bone from the ulnar side and the proximal end; the recurrent branch of the deep branch of the ulnar palmar artery enters the ulnar and distal sides of the bone along the ulnar side of the ligamentum hook. In addition, the tendon of the flexor Carpi ulnaris attached to the proximal end of the pea bone is attached to the ulnar flexor tendon. The distal abductor muscle and the transverse ligaments of the wrist, ligamentum hook, ligamentum palmaris and ulnar collateral ligament are also directly or indirectly nourished the bone. 3. The nutrient arteries and their branches of the pea bone were formed along the capsular of the pea-triangular joint and around the pea bone, respectively. 4. Diameter and length of the main nourishing vessels of the pea bone. 1) the superior cutaneous branch of ulnar artery originated from the medial side of the ulnar artery from 41.502 鹵5.247 mm above the proximal end of the pea bone, and the external diameter of the starting segment was 1.443 鹵0.070 mm. the superior cutaneous branch of the ulnar artery was further divided into the ascending branch and the descending branch. The origin of the descending branch was 1.232 鹵0.080 mm in diameter and distributed to the ulnar and proximal end of the pea bone. The descending branch of the superior cutaneous branch of the ulnar artery was used as the pedicle to transfer the pea bone, and the length of the vascular pedicle was 50.057 鹵
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類(lèi)號(hào)】：R687;R322

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 吳強(qiáng),高雁卿,陳躍軍;保留月骨骨殼帶蒂豌豆骨植入治療月骨無(wú)菌性壞死[J];實(shí)用手外科雜志;1999年03期

2 卓乃強(qiáng),魯曉波;帶蒂豌豆骨移植并腕骨局限融合術(shù)治療月骨缺血性壞死[J];實(shí)用醫(yī)院臨床雜志;2004年01期

3 吳征,張漢床,程維;骨康泰靈局部注射治療腕舟骨缺血性壞死2例臨床報(bào)道[J];中國(guó)中醫(yī)骨傷科雜志;2002年04期

4 聞勝華，，陳好德，鄭放，姚作賓;月骨豌豆骨的血供及其臨床意義[J];中華骨科雜志;1994年03期

5 裴福興,楊志明,黃富國(guó),張世瓊;帶蒂豌豆骨移位替代月骨治療月骨缺血性壞死[J];中華骨科雜志;1996年01期

6 李濤,楊志明;月骨摘除及豆?fàn)罟侵踩胪蠊堑膽?yīng)力研究[J];中華手外科雜志;1996年02期

7 路來(lái)金,張志新,劉志剛,宮旭,于家傲;頭狀骨移位替代壞死月骨的解剖研究及其臨床應(yīng)用[J];中華手外科雜志;1999年03期

8 裴福興，楊志明，黃富國(guó)，沈懷信;腕骨間融合聯(lián)合帶蒂豌豆骨移位治療月骨缺血性壞死[J];中華手外科雜志;1995年03期

9 路來(lái)金,王江寧,張志新,劉志剛,張冠軍;腕月骨無(wú)菌性壞死的診斷、分類(lèi)和治療[J];中華手外科雜志;1998年01期

10 鐘桂午,胡萬(wàn)華,閆毅,許可才,張正治,楊志明;帶蒂豌豆骨移位治療月骨無(wú)菌性壞死[J];中華醫(yī)學(xué)雜志;1996年01期

本文編號(hào)：1513328