副神经血供的解剖学研究及临床意义

目的　解剖观察副神经血供来源及血供形式，为临床带血管蒂副神经移植及带血管的肌肉神经复合皮瓣的应用提供形态学依据。 方法 15例（30侧）新鲜尸体动脉灌注乳胶和聚乙烯醇-氧化铋造影显微解剖与X线摄影，观测副神经滋养血管来源、分支及起始外径、血管起始处到副神经的垂直距离、动脉伴副神经走行的最远距离及副神经血供特点。 结果 副神经的血供呈节段性分布，有枕动脉、颈浅动脉、颈横动脉和肩胛背动脉，营养副神经的主干支血管起始处外径依次为（1.5±0.5）、（2.3±0.2）、（2.1±0.3）、（1.8±0.5）mm，各血管起始处至副神经的垂直距离依次为（1.6±0.6）、（4.6±0.4）、（4.8±0.7）、（1.0±0.3）cm，发出数支分支血管进入副神经主干及分支, 伴行副神经走行的距离依次为（4.1±0.7）、（7.3±0.6）、（8.6±0.6）、（8.5±0.5）cm。 结论 副神经血供为枕动脉、颈浅动脉、颈横动脉、肩胛背动脉以及各自的分支节段血管，为副神经神经移术时应重点加以保护。

Applied anatomy and significance of blood supply of accessory nerve

Objective To study the blood supply source and style of accessory nerve to provide a reliable anatomical basis for transfer of the vascularized accessory nerve and the vascularized neuro-muscular compound skin flap. Methods 15 fresh specimen underwent arterial perfusion of foam rubber and polyvinyl alcohol-oxidation bismuth and plain radiography to study the external diameter of nutrient vessel of accessory nerve at its origin, the distance between the origin and the accessory nerve, the farthest distance from the accompany artery to accessory nerve, feature of blood supply of accessory nerve. Results The sources of blood supply of accessory nerve came from the occipital artery, superficial cervical artery,transverse cervical artery, dorsal scapular artery. External diameter of the stem of the r nutrient arteries of the accessory nerve at the origin was（1.5±0.5）mm,（2.3±0.2）mm,（2.1±0.3）mm,（1.8±0.5）mm, respectively. The distance from the origin of the blood vessel to accessory nerve was（1.6±0.6）cm,（4.6±0.4）cm,（4.8±0.7）cm,（1.0±0.3）cm, respectively. The major blood vessels that traveled with the accessory nerve for（4.1±0.7）cm,（7.3±0.6）cm,（8.6±0.6）cm,（8.5±0.5）cm, sequentially. Conclusions The sources of blood supply of accessory nerve come from the occipital artery, superficial cervical artery, transverse cervical artery, dorsal scapular artery and they should be cautiously protected in transfer of the vascularized accessory nerve.