中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (1): 1-4.doi: 10.13418/j.issn.1001-165x.2015

• 应用解剖 •    下一篇

副神经血供的解剖学研究及临床意义

彭福森1,2,    杜友红2,    张欣1,    张艳红2,    陈飞3,    石小田3   

  1. 1.中南大学湘雅医院耳鼻咽喉头颈外科,  长沙 410008;   2.娄底市中心医院耳鼻咽喉头颈外科,
    湖南 娄底 417000;   3.海南医学院解剖学实验室, 海口  571199
  • 收稿日期:2014-07-02 出版日期:2015-01-25 发布日期:2015-02-12
  • 通讯作者: 杜友红,主任医师, Tel:15873867227, pengsenxh@163.com E-mail:513362093@qq.com
  • 作者简介:彭福森(1981-),男,主治医师,在读博士,主要从事耳鼻咽喉头颈部研究,Tel:18274814536
  • 基金资助:

    湖南省科技厅项目(2012SK3087); 湖南省卫生厅项目(B2012-151); 2012年地方高校国家级大学生创新训练项目(201211810078)

Applied anatomy and significance of blood supply of accessory nerve

PENG Fu-sen 1,2,    DU You-hong 2,    ZHANG Xin 1,    ZHANG Yan-hong 2,    CHEN Fei 3,    SHI Xiao-tian 3   

  1. 1. Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital Central South University, Changsha 410008, China;    2. Department of Otolaryngology Head and Neck Surgery, Hunan Loudi Center Hospital, Loudi 417000, Hunan province, China;   3. Department of Anatomical Lab, Hainan Medical College, Haikou 571199, China
  • Received:2014-07-02 Online:2015-01-25 Published:2015-02-12

摘要:

目的 解剖观察副神经血供来源及血供形式,为临床带血管蒂副神经移植及带血管的肌肉神经复合皮瓣的应用提供形态学依据。 方法   15例(30侧)新鲜尸体动脉灌注乳胶和聚乙烯醇-氧化铋造影显微解剖与X线摄影,观测副神经滋养血管来源、分支及起始外径、血管起始处到副神经的垂直距离、动脉伴副神经走行的最远距离及副神经血供特点。  结果    副神经的血供呈节段性分布,有枕动脉、颈浅动脉、颈横动脉和肩胛背动脉,营养副神经的主干支血管起始处外径依次为(1.5±0.5)、(2.3±0.2)、(2.1±0.3)、(1.8±0.5)mm,各血管起始处至副神经的垂直距离依次为(1.6±0.6)、(4.6±0.4)、(4.8±0.7)、(1.0±0.3)cm,发出数支分支血管进入副神经主干及分支, 伴行副神经走行的距离依次为(4.1±0.7)、(7.3±0.6)、(8.6±0.6)、(8.5±0.5)cm。 结论    副神经血供为枕动脉、颈浅动脉、颈横动脉、肩胛背动脉以及各自的分支节段血管,为副神经神经移术时应重点加以保护。

关键词: 副神经, 血供, 应用解剖

Abstract:

Objective   To study the blood supply source and style of accessory nerve to provide a reliable anatomical basis for transfer of the vascularized accessory nerve and the vascularized neuro-muscular compound skin flap.   Methods   15 fresh specimen underwent arterial perfusion of foam rubber and polyvinyl alcohol-oxidation bismuth and plain radiography  to study the external diameter of nutrient vessel of accessory nerve at its origin, the distance between the origin and the accessory nerve, the farthest distance from the accompany artery to accessory nerve, feature of blood supply of accessory nerve.   Results   The sources of blood supply of accessory nerve came from the occipital artery, superficial cervical artery,transverse cervical artery, dorsal scapular artery. External diameter of the stem of the r nutrient arteries of the accessory nerve at the origin was(1.5±0.5)mm,(2.3±0.2)mm,(2.1±0.3)mm,(1.8±0.5)mm, respectively. The distance from  the origin of the blood vessel to accessory nerve was(1.6±0.6)cm,(4.6±0.4)cm,(4.8±0.7)cm,(1.0±0.3)cm, respectively. The major blood vessels that traveled with the accessory nerve for(4.1±0.7)cm,(7.3±0.6)cm,(8.6±0.6)cm,(8.5±0.5)cm, sequentially.   Conclusions    The sources of blood supply of accessory nerve come from the occipital artery, superficial cervical artery, transverse cervical artery, dorsal scapular artery and they should be cautiously protected in  transfer of the vascularized accessory nerve.

Key words: Accessory nerve, Blood supply, Applied anatomy

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