冈上肌腱修改稿2.doc

冈上肌腱修改稿2
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 徐达传3
(1长江大学医学院,荆州 434000;2南方医院骨科, 广州510515;3南方医科大学解剖学
教研室,广州 510515)
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(±) mm,主干长(±) 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(±) 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。
关键词冈上肌;肌腱;肩袖
Character of blood supply for the supraspinatus and its clinical significance Xu Benke1△, Yang Yunping2, Liu Hongtao1, Luo Gang1, Liu Bing1,
Liu Benju1, Xu
Chuanda3
( College ,Yangtze University, Jingzhou 434000; of Osteology of Southern Hospital, Guangzhou 510515; of Anatomy of Southern Medical University, Guangzhou 510515, China)
Abstract Objective: To provide the anatomic basis of blood supply for the prevention and treatment of shoulder joint disease and the reconstruction of shoulder joint function. Methods: 40 sides upper limbs of routine anticorrosive adult cadavers perfused by red emulsion were used. Supraspinatus was dissected. The morphosis, enthesis, origin of blood supply, course and distribution character of supraspinatus were observed. Related data was measured. Results: The blood supply of su