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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 a theoretical basis for seeking new ways to relieve spastic paralysis of upper limbs. Methods: Anatomical observation of 43 adult upper limbs under a surgical microscope was performed. To understand the spastic cerebral palsy caused by upper extremity spastic flexor elbow, pronation and flexor deformity of the active muscle nerve branch of the source, diameter, detachable length and issue site. Results: The bifidus muscle branches averaged 2.72 branches, which originated from the musculocutaneous nerve (97.5%) and the median nerve (2.5%). The mean muscular branches of the brachial muscle were 2.74 branches and the origin of the musculocutaneous nerve (80. 5%), and the rest were derived from the radial nerve (5.3%), median nerve (4.2%); brachioradialis muscle anastomosis an average of 1.77, derived from the radial nerve; 33, from the median nerve; flexor carpi ulnaris muscle branch an average of 1.72, derived from the ulnar nerve. Their separable length were: biceps femoris 2 3.94mm, brachial muscle branch 21.36mm, brachioradialis muscle branch 21.38mm, pre pronator myone branch 2 7.2 7mm, ulnar Flexor flexor muscle branch 2 1 .70mm. The diameters of the nerve branches were 0 .99, 1.00, 0.86, 0.84, 0.83 mm respectively. There was no significant difference in the diameter between the start and the entrance to the muscular door (t test) (P> 0.05). CONCLUSION: The diameter of nerve branch is considered to be related to the number of nerve. The length of resection can be selectively cut off at the beginning of operation.