Del Pinãl F, Taylor G I
Department of Plastic Surgery, Royal Melbourne Hospital, Australia.
Br J Plast Surg. 1990 Sep;43(5):511-20. doi: 10.1016/0007-1226(90)90113-e.
The venous drainage of the peripheral nerves was studied in the upper and lower limbs of two human fresh cadaver subjects after total body perfusion with a radio-opaque lead oxide mixture. Four patterns of extraneural drainage were identified in which the venae nervosa drained: directly to the venae comitantes of the neurovascular bundle; indirectly via nearby veins, derived usually from muscles; to the periarterial venous plexus; or, in the case of the cutaneous nerves, to the perivenous plexus. The various patterns of the drainage along the length of the radial, median, ulnar, sciatic, anterior and posterior tibial nerves were identified. A rich longitudinal plexus of veins exists on and within the nerve which appears to be mainly free of valves. The large venae nervosa usually contained valves, whereas the tiny veins draining the nerves were valveless or exhibited a sentinel valve at their entry point into a larger venous channel. The clinical implications of these results are discussed in relation to the mobilisation of nerves, the use of island nerve flaps, possible donor sites for free arteriolised neurovenous flaps and the compressive nerve syndromes.
在两名新鲜人体尸体的上下肢，用不透射线的氧化铅混合物进行全身灌注后，对周围神经的静脉引流情况进行了研究。确定了四种神经外引流模式，其中神经静脉引流至：神经血管束的伴行静脉；通常经附近源自肌肉的静脉间接引流；至动脉周围静脉丛；或者，对于皮神经而言，引流至静脉周围丛。确定了沿桡神经、正中神经、尺神经、坐骨神经、胫前神经和胫后神经全长的各种引流模式。在神经表面和内部存在丰富的纵向静脉丛，这些静脉丛似乎基本无瓣膜。大的神经静脉通常有瓣膜，而引流神经的小静脉无瓣膜，或在其汇入较大静脉通道的入口处有一个哨兵瓣膜。结合神经的游离、岛状神经皮瓣的应用、游离动脉化神经静脉皮瓣可能的供区以及压迫性神经综合征，讨论了这些结果的临床意义。
