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目的:探讨指髓解剖和组织形态学特点,为临床治疗指端感染提供理论基础。方法:男性成人新鲜手指标本240例(示、中、环、小指各60例,左侧30,右侧30),用尖刀在手指末节正中纵向切开至骨膜,用摆锯纵向劈开末节指骨,完整显露手指末节矢状面,用游标卡尺(0.02mm)分别测量手指末节长度L(1指端至指远纹的长度)和指髓间隙L(2指端处最远纤维隔至近端最近纤维隔的距离),做冠状面和矢状面的HE染色。结果:双侧示、中、环、小指L1和L2的长度无显著性差异(P>0.05),双侧示、中、环、小指的L2/L1均大于50%;组织学研究表明,指髓是由若干垂直走行的纤维隔形成的密闭间隙,纤维隔将脂肪分成脂肪小叶,其间有血管和神经末梢分布。结论:指髓特殊的解剖和组织形态学决定了在指端感染切开过程中尽可能保留指髓的解剖结构,为防止感染沿近端屈肌腱鞘扩散,切开范围不应超过其相应手指末节长度的50%。
Objective: To investigate the characteristics of finger pulp anatomy and histomorphology and provide the theoretical basis for clinical treatment of finger-tip infection. Methods: A total of 240 adult male fresh finger samples (60 for the middle, the middle ring and the little finger, 30 for the left and 30 for the right) were cut longitudinally to the periosteum in the middle of the distal part of the finger with a sharp knife, , Revealing the sagittal plane of the distal part of the finger completely. The length of the distal part of the finger L (the length of the finger from one finger to the reticle) and the distance L (the farthest end of the finger at the fingertip to the proximal end) were measured respectively with a vernier caliper (0.02mm) Fiber distance), do coronal and sagittal HE staining. Results: There was no significant difference in the length of L1, L2 between the middle, middle ring and the little finger (P> 0.05). The L2 / L1 of the middle, middle, ring and little finger were all more than 50% The medulla is a closed gap formed by a number of vertically running fibers. The fibrous septum divides the fat into fatty lobular with the distribution of blood vessels and nerve endings. CONCLUSIONS: The special anatomy and histomorphology of the finger means that the anatomy of the nail should be preserved as much as possible during incisional wound infection. In order to prevent the spread of infection along the proximal flexor tendon sheath, the incision range should not exceed that of the corresponding finger Minute length of 50%.