冈上肌腱的血供特点及临床意义

许本柯, 杨运平, 刘洪涛, 罗钢, 刘兵, 刘本菊

中国临床解剖学杂志 ›› 2012, Vol. 30 ›› Issue (1) : 33-35.

中国临床解剖学杂志 ›› 2012, Vol. 30 ›› Issue (1) : 33-35.
应用解剖

冈上肌腱的血供特点及临床意义

  • 许本柯1, 杨运平2, 刘洪涛1, 罗 钢1, 刘 兵1, 刘本菊1
作者信息 +

Blood supply of the supraspinatus and its clinical significance

  • XU Ben-ke1, YANG Yun-ping2, LIU Hong-tao1, LUO Gang1, LIU Bing1, LIU Ben-ju1
Author information +
文章历史 +

摘要

目的 为肩关节疾患的防治及肩关节功能的重建提供血供解剖学基础。  方法 采用40侧常规防腐灌注红色乳胶的成人上肢标本,解剖出冈上肌观察其形态结构、起止点、血供来源、走行、分布特点并测量有关数据。  结果 冈上肌的血供主要来自肩胛上动脉和颈横动脉降支。肩胛上动脉起始处外径为(2.9±0.3) mm,主干长(4.8±0.7) cm;营养冈上肌肌支在肩胛横韧带的上方或下方分为2~3支进入肌腹。其入肌点位于肩胛横韧带的前下方(1.9±0.2) mm;冈上肌腱在移行部和扩展部动脉吻合丰富,而在实质部距肌腱止点部1 cm处毛细血管稀疏,是一个明显的乏血管区。冈上肌的神经支配主要是肩胛上神经,与血管伴行分2~3支支配冈上肌。  结论 肩袖撕裂或肩袖损伤考虑行手术修复时,不宜采取简单的断端缝合,应将断端的缺血组织切除后再行缝合或采用合适的肌腱代用材料进行修补,改善局部血供,有利于愈合。

Abstract

Objective To provide anatomic basis of blood supply for preventing and treating of shoulder joint disease and reconstructing of shoulder joint function. Methods 40 specimens of adult upper limbs fixed and perfused with red emulsion were used. Supraspinatus was dissected for exploring its anatomic features. Results The blood supply of supraspinatus was mainly from the suprascapular artery and the descending branch of transverse cervical artery. The outer diameter at the beginning was (2.9±0.3) mm, and the length of main trunk was (4.8±0.7) cm. The muscular branches supplying supraspinatus divided into two to three branches to enter the muscle belly above or below the scapula ligamentum transversum. The place of the branches entering the muscle belly located at the point (1.9±0.2) mm antero-inferior to the scapula ligamentum transversum. The arterial anastomosis of tendon of supraspinatus was affluent at the transmigration part and expansion part. While the capillary was rare at the place 1 cm distal to the insertion of tendon in the parenchyma part, which was a apparent area lacking of blood vessels. The supraspinatus was mainly innervated by suprascapular nerve, which divided into two to three branches accompanied by blood vessels to innervate supraspinatus. Conclusions On repairing of the rotator cuff tear or injury, it is unsuitable to simply sew the broken end. The broken end sew should be performed after cutting the ischemic tissue or transferring suitable tendon medium, for improving the regional blood supply, which is helpful for healing.

关键词

冈上肌 / 肌腱 / 肩袖

Key words

 Supraspinatus / Tendon / Rotator cuff

引用本文

导出引用
许本柯, 杨运平, 刘洪涛, 罗钢, 刘兵, 刘本菊. 冈上肌腱的血供特点及临床意义[J]. 中国临床解剖学杂志. 2012, 30(1): 33-35
HU Ben-Ke, YANG Yun-Beng, LIU Hong-Chao, LUO Gang, LIU Bing, LIU Ben-Ju. Blood supply of the supraspinatus and its clinical significance[J]. Chinese Journal of Clinical Anatomy. 2012, 30(1): 33-35
中图分类号: R323.24   

参考文献

[1]  凌树才,陈昌富,万人欣.冈上肌腱血液供应的研究[J].中国临床解剖学杂志, 1990,8(2):67-70.
[2]  张潜,徐风生,薛黔.人肌腱袖肌群的构筑学研究[J].四川解剖学杂志,1996,3(4):202-204.
[3]  赵延旭,顾立强,徐达传.肩袖合并肩胛上神经损伤原因的解剖学研究[J].中国临床解剖学杂志,2006,24(6):627-630.
[4]  童建军.肩袖损伤的形态学研究进展及临床意义[J].中国娇形外科杂志,2005.13(14):1102-1104.
[5]  顾立强,裴国献.周围神经损伤基础与临床[M].北京:人民军医出版社, 2001,209-212.
[6] Asami A, Sonohata M, Morisawa K. Bilateral suprascapular nerve entrapment syndrome associated with rotator cuff tear[J]. J Shoulder Elbow Surg, 2000,9(1):70-72.
[7]  刘国明,黄富国,秦延武.巨大肩袖撕裂的治疗及研究进展[J].中国修复重建外科杂志,2011,25(1):61-65.


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