Abstract

目的 研究副神经移位到肩胛上神经以恢复臂丛神经损伤患者肩外展功能的后进路术式.方法选用陈旧尸体10具20侧,新鲜尸体4具8侧,解剖观测在肩胛冈上缘水平副神经和肩胛上神经的关系.设计后进路副神经移位到肩胛上神经的新术式,并试用于临床.结果肩胛上神经100%(28/28)位于肩胛横韧带深侧的肩胛上切迹内,位置恒定;副神经降支行于斜方肌深面、筋膜下,在肩胛冈上缘水平位于肩胛骨内侧缘[(10.42±4.24)mm,±s,下同],在该水平与肩胛上神经的最近距离为(4.94±1.22)cm.游离切断后,可与肩胛上神经在无张力下直接拉拢缝合.临床试用于10例病人,均顺利完成副神经移位到肩胛上神经的手术.术后检查斜方肌上部肌力无明显影响. 结论后进路副神经移位到肩胛上神经的术式是安全的、可行的。

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