人缝匠肌肌构筑特征与肌内神经分布及其临床应用张;編号薛黔杨宇平2（519041珠海，遵义医学院珠海校区：解剖学教研室刊（H）开弑解剖学教研室'；510080广州，中山大学医学部彳）［提要］目的研究缝匠肌肌构筑特征和肌内神经分支分布，为缝匠肌的临床外科肌移植捉供详尽的形态学资料。方法用大体解剖法解剖并观察测星20具尸体缝匠肌的肌构筑学特征；用改良SihlcrM肌内神经染色法，探讨10具尸体缝匠肌肌内神经分支分布。结果缝匠肌是一块由长肌朿平行排列构成的带状肌，肌重(97.9±13.3)g,肌长(47.3±4.3)cm,肌纤维长(40.0±3.8)cm,羽状角(0)°,生理横切面积(1.96±2.3)cm2；缝匠肌有2支一级神经支支配，发出分支支配肌的上部和中下部，且两部肌内神经分支分布相互独立。结论缝匠肌有2支一级神经支支配，神经支配有一定的区域性：缝匠肌肌内神经的分支分布与肌构筑学特点有关：根据肌内神经分支分布进一步证实缝匠肌可分为上部和中下部两个亚部，为临床外科进行缝匠肌移植或亚部化移植提供形态学依据。［关键词］肌构筑；肌内神经；肌移植；缝匠肌；人［中图法分类号］R322.74［文献标识码］AThemusclearchitecture,innervationandtheirclinicalapplicationinhumansartoriusZhangHongwu",XueQian',YangYuping2('DepartmentofAnatomy,TheZhuhaiCampusofZunyiMedicalCollege,Zhuhai,519041;DepartmentofAnatomy,ZunyiMedicalCollege,Zunyi,563003;^FacultyOfllceofMedicalScienceofSunYat-senUniversity;Guangzhou510080,China)［Abstract］ObjectiveThepurposeofthisstudywastoprovideamorphologicbasisforclinicalapplicationbydeterminingthemusclearchitectureandthepatternofintramuscularnervebranchwithinsartorius.MethodsArchitecturalfeatureofsartoriuswasstudiedbyusingthegross-anatomyfrom20humanadultcadavers；ModifiedSihler^sneuralstainingtechniquewasusedtoobservetheintramuscularnervebranchpatternin10humancadavers.ResultsSartoriuswasakindofribbonmusclewhichwascomposedoflongfascicle.Theaveragemusclemass,musclelength,fiberlength,pinnateangle,andcrosssectionalareaofsartoriuswere(97.9±13.3)g,(47.3±4.3)cm,(40.0±3.8)cm,(0)(1.96±2.3)cm2,respectively.Sartoriushad2primarybranchesenteredthemuscleandbranchedintoseveralsecondarybrancheswhichdistributedtosuperiorportionandmedialinferiorportion,respectively.ConelusionSartoriushadtwoprimarybranchesdistributedtocertainregion.Theintramuscularnervebranchpatternhadacloserelationtocharacteristicofthemusculararchitecture・Sartoriuscouldbedividedfiirtherintothesuperiorandmedialinferiorcompartmentsaccordingtothedistributionoftheintramuscularnervebranchesinit.Thesuperiorandmedialinferiorcompartmentsofsartoriuscouldbeusedformuscletransplantationsolely.［Keywords］musclearchitecture;intramuscularnerve;muscletransplantation;sartorius;humanSupportedbytheScienceandtechnologyresearchprojectsofMinistryofEducationofChina(02136Program).Correspondingauthor:XueQian,Tel:138・85239305,E-mail:xueqian()852@126.com［基金项目］教育部科学技术研究垂点项目资助课题（02136）;逍义医学院硕士科研基金资助课题（F222）［通信作者］薛黔，电话:138-85239305,E-mail:xucqian0852@126.com缝匠肌是临床外科肌移植常选用肌之一，有关缝匠肌的形态、血供、神经支配已有大量的研究[陀讥经查阅近10年文献，未见缝匠肌肌内神经分支分布的报道。本研究则进一步探讨缝匠肌产生张力的大小、缩短速度和位移幅度，并采用改良的SihleFs肌内神经染色法⑷探讨缝匠肌肌内神经分支分布及其肌亚部情况，为临床应用亚部化肌移植提供较为详尽的形态学依据。1材料与方法1.1肌构筑学用经甲醛固定的成人尸体20具，完整取下左右侧缝匠肌(共40块)。除去肌表面筋膜和脂肪，仔细观察肌形态、肌起止点和肌朿走行，测童以下肌构筑指数：肌重(muscleweight,MW)；肌长(musclelength,M...