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胫神经近端肌支转位修复腓深神经的可行性研究
A FEASIBILITY STUDY ON TRANSPOSITION OF PROXIMAL MOTOR BRANCHES FROM TIBIAL NERVE TO RECONSTRUCT DEEP FIBULAR NERVE
 [PDF]

蔡雨卫,侯春林
- , 2015, DOI: 10.7507/1002-1892.20150014
Abstract: 目的探讨胫神经近端肌支转位修复腓深神经的可行性,为手术治疗高位腓总神经损伤提供解剖学依据。 方法取8具新鲜冷冻尸体双下肢标本以及由3例高位截肢术患者自愿捐赠的新鲜下肢标本(左侧2具、右侧1具),解剖腘窝部各神经,测量胫神经3条运动分支(比目鱼肌支和腓肠肌内、外侧头肌支)长度、直径及其发出点至腓总神经分支点的距离,腓深神经无损伤分离束长度及直径,评价各条运动支与腓深神经束行无张力吻合的可行性。切取以上神经分支行HE及乙酰胆碱酯酶染色观察,计数神经纤维。 结果大体解剖观察示,腓肠肌内、外侧头肌支及比目鱼肌支发出点至腓总神经分支点之间的距离分别为:(71.44±2.76)、(75.66±3.20)、(67.50±3.22)mm;以上各分支以及腓深神经无损伤分离束长度分别为(31.09±2.01)、(38.44±2.38)、(59.18±2.72)、(66.44±2.85)mm,直径分别为(1.72±0.08)、(1.88±0.08)、(2.10±0.10)、(2.14±0.12)mm。组织学观察示腓肠肌内、外侧头肌支、比目鱼肌支、腓深神经无损伤分离束运动神经纤维数分别为(2032±58)、(2186±24)、(3102±85)、(3512±112)根。比目鱼肌支直径以及运动神经纤维数与腓深神经无损伤分离束相似( P>0.05),腓肠肌内、外侧头肌支以上指标均显著低于腓深神经无损伤分离束( P<0.05)。 结论胫神经腘窝部3条运动神经分支均可直接转位吻合腓深神经无损伤分离束修复高位腓总神经束损伤,其中比目鱼肌支为首选供体神经。
ObjectiveTo explore the feasibility of transposition of the proximal motor branches from tibial nerve (TN) as direct donors to suture the deep peroneal nerve (DPN) so as to provide a basis for surgical treatment of high fibular nerve injury. MethodsNineteen lower limb specimens were selected from 3 donors who experienced high-level amputation (2 left limbs and 1 right limb) and 8 fresh frozen cadavers (8 left limbs and 8 right limbs). The length and diameter of the three motor branches from TN (soleus, medial gastrocnemius, and lateral gastrocnemius) and the distance from the initial points to the branch point of the common peroneal nerve (CPN), as well as the length and diameter of the noninvasive separated bundles of DPN, then the feasibility of tensionless suturing between the donor nerves and the DPN bundle was evaluated. At last, part of the nerve tissue was cut out for HE and Acetylcholine esterase staining observation and the nerve fiber count. ResultsGross anatomic observation indicated the average distance from the initial points of the three donor nerves to the branch point of the CPN was (71.44±2.76) (medial gastrocnemius), (75.66±3.20) (lateral gastrocnemius), and (67.50±3.22) mm (soleus), respectively. The three donor nerves and the DPN bundles had a mean length of (31.09±2.01), (38.44±2.38), (59.18±2.72), and (66.44±2.85) mm and a mean diameter of (1.72±0.08), (1.88±0.08), (2.10±0.10), and (2.14±0.12) mm, respectively. The histological observation showed the above-mentioned four nerve bundles respectively had motor fiber number of 2 032±58, 2 186±24, 3 102±85, and 3 512±112. Soleus nerve had similar diameter and number of motor fibers to DPN bundles ( P>0.05), but the diameter and number of motor fibers of the medial and lateral gastrocnemius were significantly less than those of DPN bundles ( P<0.05). ConclusionAll of the three motor branches from TN at popliteal
全关节镜下距腓前韧带重建治疗慢性外踝撕脱骨折  [PDF]
张晋,王雪松,冯华
第三军医大学学报 , 2015,
Abstract: 目的探讨使用全关节镜下距腓前韧带重建治疗陈旧外踝撕脱骨折的手术技巧、临床疗效及手术并发症等。方法2013年1-11月本科对14例陈旧外踝撕脱骨折患者进行全关节镜下距腓前韧带重建,包括女性8例,男性6例,平均年龄30.5(18~40)岁。通过胫前小切口取半腱肌作为移植物。全关节镜下于腓骨侧进行骨槽制备和1枚缝合锚钉固定,距骨侧使用可吸收挤压螺钉固定。平均随访12(8~18)个月。使用AOFAS评分进行临床疗效和患者满意率的评估,并使用Telos装置对患者术前和术后的应力位片进行测量。结果平均AOFAS评分由术前(73.4±16.4)分改善至术后(?95.7±?6.1)分(P<0.01)。无患者主诉术后仍有不稳定感,且无供区疼痛和肌力下降主诉。Telos装置应力位片测量由术前(11.4±3.1)mm改善至术后(2.8±0.6)mm(P<0.01)。结论使用半腱肌进行全关节镜下距腓前韧带重建可以明显改善踝关节不稳定且无特殊手术并发症。
百 合 鳞 片 快 繁 试 验 研 究  [PDF]
王海新,赵 艳,崔雪艳
北方园艺 , 2010, DOI: 10.11937/bfyy.201017056
Abstract:
红 掌 苗 期 施 肥 试 验 研 究  [PDF]
许震寰1,,唐霄铧1,,白为1,,卓 明1,孙 婷1
北方园艺 , 2010, DOI: 10.11937/BFYY.201017045
Abstract:
机械筑埽技术研究  [PDF]
张佑民,苏本超,梅龙
人民黄河 , 2008,
Abstract: ?分析了机械修筑传统埽体、柳石混杂机械筑埽和层柳层石机械筑埽的施工工艺,与人工作业筑埽相比,作业优势明显,可在黄河防汛抢险中大力推广.
蔡福养教授运用会厌逐瘀汤治疗咽部疾病验案四则  [PDF]
蔡继堂,仝选甫
中国中医药信息杂志 , 1999,
Abstract: 全国第二批名老中医学术经验继承人导师蔡福养,长于运用经方辨证施治治疗耳鼻喉疾病,今将其临床应用会厌逐瘀汤治疗咽部疾病的验案整理如下,以兹佐证。探病究源,紧守方义会厌逐瘀汤出自《医林改错》,系王清任所创诸逐瘀汤之一。
麝腓腺生长发育与化学通讯机能的探讨  [PDF]
倪荷芳,王心乐,李贵全,杨昌金,颜于宏,毕书增
兽类学报 , 1996,
Abstract: ?本文对麝的腓腺进行了生长发育与组织化学观寨。腓腺由丰富的顶泌汗腺组成,分泌混合性粘多糖成分的信息素。出生80日龄幼麝的腓腺开始有分泌功能,成体时其分泌功能旺盛。麝以直接和间接方式释放信息素。
模糊预后验决策  [PDF]
系统工程理论与实践 , 1994,
Abstract: ?本文旨在把模糊数学方法同贝叶斯决策中的预后验决策方法相结合,提供了一个处理这类决策中出现的一些模糊性的方法。这种方法适用范围更广,更接近日常生活中遇到的决策问题。
下胫腓联合的生物力学研究进展  [PDF]
陈大伟,李兵,俞光荣
- , 2015, DOI: 10.3871/j.1004-7220.2015.01.094.
Abstract: 下胫腓联合的各条韧带具有不同的生物力学作用,在踝关节活动过程中下胫腓联合存在微动,并且下胫腓联合的损伤与踝关节体位和受力方式有关。关于下胫腓联合的最优固定仍存有争议,下胫腓联合的畸形复位会导致踝关节压力分布异常,弹性固定可能更符合下胫腓联合的生理活动。回顾下胫腓联合的生物力学研究进展,旨在为下胫腓联合损伤的合理治疗提供参考。
Each of the syndesmotic ligaments has different biomechanical effects. Minimal movement occurs in the syndesmosis during the motion of the ankle joint, and the syndesmotic injury is associated with the ankle position and the patterns of external forces. Controversy still exists with respect to the optimal fixation of the syndesmosis. Malreduction of the syndesmosis would lead to abnormal pressure distribution on the ankle joint. Therefore, the flexible fixation might more accord with the physical movement of the syndesmosis. In this article, the biomechanical studies on syndesmosis are reviewed to provide the reference for proper treatment method for syndesmotic injury.
金 花 茶 嫁 接 繁 殖 试 验 研 究  [PDF]
张乃燕,王东雪,江泽鹏,梁文汇,韦晓娟
北方园艺 , 2010, DOI: 10.11937/bfyy.201021010
Abstract:
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