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目的 观察T11、T12 神经在腹直肌内及穿出前鞘后分布于下腹部皮肤的规律 ,分析横形腹直肌肌皮瓣 (transverserectusabdominismusculocutaneousflap ,TRAM )形成与T11、T12 神经相关的应用解剖学基础及手术要点。方法 在 11具 2 2侧常规防腐固定的成人尸体上 ,解剖并观测腹前外侧壁局部结构。结果 TRAM的皮神经来自T11、T12 神经前支。其主干在腹横肌与腹内斜肌之间斜行走行较长距离 ,经腹直肌外缘鞘融合后入腹直肌后面 ,除分出肌支支配腹直肌外 ,有外侧穿支、内侧穿支和升穿支分布于皮肤。结论 根据以上解剖特点 ,TRAM皮瓣可以设计以T11、T12 前支为神经蒂的感觉皮瓣 ,用于乳房再造时 ,具有感觉恢复快的独特优点
Objective To observe the distribution of T11 and T12 nerves in the rectus abdominis muscle and the anterior sheath and the distribution of the T11 and T12 nerves in the skin of the lower abdomen, and to analyze the anatomical basis of the application of transverserectus abdominis musculocutaneousflap (TRAM) And surgery points. Methods 11 adult 22 cases of conventional anticorrosive fixed carcasses, anatomy and observation of the anterior abdominal wall of the local structure. Results The dermal nerves of TRAM came from T11 and T12 anterior branches. The trunk in the transverse abdominal muscle and abdominal oblique oblique line to walk a long distance, the rectus abdominis sheath fused into the back of the rectus abdominis muscle, in addition to the branch of muscular branches supporting the rectus abdominis, the lateral perforator , The medial wear branch and lumbar puncture distributed in the skin. Conclusion According to the above anatomical features, TRAM flap can be designed with T11, T12 anterior pedicle for the sensory flap of the nerve pedicle, breast reconstruction, with the unique advantages of rapid recovery feeling