腕部动脉网的巨微解剖

在手术显微镜下,解剖观察了50侧用红色乳胶灌注动脉的成人上肢标本。共有12个动脉源参加腕部的动脉网。腕部动脉网在背侧有三个层次,掌侧有两个层次。位于腕关节囊掌侧和背侧的动脉网最为完整,是腕部动脉吻合交通的主要动脉网。腕背侧动脉网,主要由桡动脉腕背支、骨间前动脉背侧支及上穿动脉上支吻合形成。腕掌侧动脉网,主要由桡动脉腕掌支、骨间前动脉掌侧支和尺动脉腕背支参加。骨间前动脉在腕部与桡、尺两动脉均有广泛吻合,但从吻合管径和吻合数量看,则具有桡侧优势。前臂动脉干与手部动脉干之间,通过腕掌侧和背侧动脉网建立的侧副吻合,则显示背侧优势。腕部的动脉网,呈现多来源、多吻合、多层次的构筑特点,与多关节、多活动、多层次的腕部结构和功能相适应。 本文从形态学上讨论了,腕部桡、尺动脉两支或任何一支在急性或慢性阻断时,腕部动脉网代偿动脉干供应手部血液的可能性。

Macro-micro-anatomy of the Arterial Network around the wrist Joint

Fifty prepared specimens of adult upper extrimity were employed in the study,The arteries of each extremity were perfused with red latex and the dissection was carried out under an operating microscope.Twelve arteries participate in the formation of the arterial network around the wrist joint.It consists of 5 divisions situated in different tissue layers,3 on the dorsal and 2 on the palmar side of the extremity.The 2 divisions situated on the dorsal and palmar side of the joint capsule of the wrist respectively are the most completely constructed among the 5,and the main routes for the collateral circulation around the wrist.The dorsal division of the carpal arterial network is mainly formed by the dorsal carpal branch of the radial artery,the dorsal branch of the,anterior in- terosseus artery,and the ascending branch of the superior perforating artery,while the palmar division by the palmar carpal branch of the radial artery,the palmar branch of the anterior interosseus artery,and the dorsal carpal branch of the ulnar artery.There are extensive and multiple anastomoses between the anterior interosseus artery and the radial and ulnar arteries with a preponderance of the anastomoses over the radial side of the extremity in regard to the size and number of the participating vessels. The collateral circulation established by the anastomoses between the dorsal and palmar divisions in preponderant over the dorsal side of the extremity.The carpal arterial network is characterized by its multiple arterial origins,multiple anastomoses and multiple divisions to conform to the poly-articular construction and multi-directional movement of the wrist joint.In addition,the compensation of the blood circulation of the hand through the carpal arterial network in ease the radial artery and/or the ulnar artery are severed or gradually obliterated was discussed morphologically.