本文關(guān)鍵詞：喉部動脈的特點(diǎn)及意義　出處：《重慶醫(yī)科大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 喉 動脈 鑄型 冰凍磨銑法 定位

【摘要】：目的研究喉部動脈分布的形態(tài)學(xué)特點(diǎn),為喉部腫瘤的三維放射治療、喉移植及喉部修復(fù)重建提供解剖學(xué)基礎(chǔ)。方法10例(1至10號標(biāo)本)結(jié)構(gòu)完整的喉部標(biāo)本鑄型,用鹽酸腐蝕,觀察喉部動脈分支,游標(biāo)卡尺測量血管經(jīng)線;20例(11至30號標(biāo)本)結(jié)構(gòu)完整的喉部標(biāo)本用過氯乙稀和硫酸鋇混合鑄型,采用美國GE Signa MR/i型1.5T等全身MR掃描儀和德國西門子Somatom Esprit CT水平面和矢狀面的掃描,獲得喉部血管的影像學(xué)數(shù)據(jù);20例(11至30號標(biāo)本)結(jié)構(gòu)完整的喉部標(biāo)本鑄型,進(jìn)行1mm/片磨銑,進(jìn)一步確定喉部動脈與周圍器官組織的位置關(guān)系,對供應(yīng)喉部血液的血管進(jìn)行定位分析;10例(31至40號標(biāo)本)動脈鑄型的喉部標(biāo)本在體視顯微鏡(coic xtl 23:7.5-30倍)下進(jìn)行觀察。對喉部動脈分支分布走行進(jìn)行定量分析。結(jié)果喉部血供主要來自甲狀腺上動脈和甲狀腺下動脈分支,左、右甲狀腺上動脈的長度為(4.2±0.2)cm和(4.0±0.2)cm,起始點(diǎn)的口徑為(1.5±0.3) mm,甲狀腺上動脈入喉后分出7個主要分支,分別為甲狀腺上動脈第1分支--第7分支,主要供應(yīng)甲狀腺包囊及結(jié)締組織,位置較淺;左、右甲狀腺下動脈的長度為(2.3±0.27)cm和(2.2±0.27) cm,起始點(diǎn)的口徑為(1.6±0.37)mm,入喉點(diǎn)口徑為(1.4±0.3) mm和(1.3±0.3) mm。沿前斜角肌內(nèi)緣上行,約至第6頸椎水平,便急轉(zhuǎn)向內(nèi),橫過頸長肌和椎動脈的前方,頸內(nèi)靜脈,頸總動脈,迷走神經(jīng)及交感神經(jīng)干的后方,至甲狀腺后緣中點(diǎn)處附近轉(zhuǎn)向下行,甲狀腺下動脈入喉后分出4個主要分支,分別為甲狀腺上動脈第1分支--第4分支,分別至甲狀腺,氣管及食管等器官。結(jié)論采用這4種不同的形態(tài)學(xué)研究方法對喉部動脈分支分布走行特點(diǎn)的觀察分析和定量研究,較詳細(xì)的獲得了喉部動脈的走行分布大小及分布位置,以及喉各部位的血管供應(yīng)情況。喉動脈鑄型標(biāo)本能較詳細(xì)清楚觀察動脈細(xì)小分支走行及分布范圍,動脈與喉部組織關(guān)系位置顯示欠佳,而MRI和CT掃描確定位喉動脈與喉部其他組織結(jié)構(gòu)組織的位置關(guān)系,但微細(xì)結(jié)構(gòu)分辨力欠佳,冰凍磨銑法可更直觀顯示喉部動脈與喉不同層面的關(guān)系,對MRI和CT掃描喉動脈血管起到很好的補(bǔ)充作用,體視學(xué)研究能準(zhǔn)確的對喉動脈分支分布數(shù)量進(jìn)行定量。影像學(xué)技術(shù)對喉腫瘤三維放射治療,喉移植及喉部位修復(fù)重建作為臨床醫(yī)療診斷和影像學(xué)檢查的重要輔助手段,更適合于臨床。
[Abstract]:Objective to study the morphological characteristics of laryngeal artery distribution in laryngeal neoplasms. Methods the cast of laryngeal specimens with intact structure was observed by hydrochloric acid corrosion, the branches of laryngeal arteries were observed, and vascular meridians were measured by Vernier calipers. 20 specimens from 11 to 30) the laryngeal specimens with intact structure were cast by mixed casting of perchloric ethene and barium sulfate. The horizontal plane and sagittal plane were scanned by GE Signa MR/i 1.5T and Siemens Somatom Esprit CT in Germany. The imaging data of laryngeal vessels were obtained. 20 specimens from 11 to 30) of larynx with intact structure were molded and milled with 1mm / slice to determine the relationship between the laryngeal artery and the surrounding organs and tissues. The blood vessels supplying laryngeal blood were analyzed. Laryngeal specimens of arterial cast in 10 specimens from 31 to 40) in stereoscopic microscope: 23: 7.5-30 times). The results showed that the blood supply of larynx mainly came from superior thyroid artery and inferior thyroid artery branch. The length of the left and right superior thyroid arteries was 4.2 鹵0.2 cm and 4.0 鹵0.2 cm respectively. The diameter of the starting point was 1.5 鹵0.3 mm. After entering the larynx, the superior thyroid artery was divided into seven main branches, the first branch and the seventh branch of the superior thyroid artery, which mainly supplied the thyroid cyst and connective tissue. The length of the left and right inferior thyroid arteries was 2.3 鹵0.27 cm and 2.2 鹵0.27 cm respectively. The diameter of the starting point was 1.6 鹵0.37 mm. The laryngeal entry point was 1.4 鹵0.3 mm in diameter and 1.3 鹵0.3 mm in diameter. It ascended along the inner edge of the anterior scalene muscle and reached the level of the 6th cervical vertebra, then quickly turned inward and crossed the front of the longus cervicalis muscle and the vertebral artery. The posterior part of internal jugular vein, common carotid artery, vagus nerve and sympathetic nerve trunk turned downward to the midpoint of the posterior edge of thyroid gland, and the inferior thyroid artery was divided into four main branches after entering the larynx. It is the first branch of the superior thyroid artery-the fourth branch, respectively, to the thyroid gland. Conclusion the characteristics of branch distribution of laryngeal artery were observed and analyzed quantitatively by using these four different morphological methods. The size and location of the laryngeal artery and the vascular supply of the laryngeal artery were obtained in detail. The patchwork of the laryngeal artery can clearly observe the route and the distribution range of the fine branches of the larynx artery. The location of the relationship between the artery and the laryngeal tissue was poor, while the location of the laryngeal artery and other laryngeal tissue was determined by MRI and CT scanning, but the resolution of the fine structure was not good. Frozen grinding and milling method can show the relationship between laryngeal artery and laryngeal artery more directly, which is a good supplement to MRI and CT scanning of laryngeal artery vessels. Stereological study can accurately quantify the number of branches of laryngeal artery. Imaging techniques for three-dimensional radiotherapy of laryngeal tumors. Laryngeal transplantation and laryngeal reconstruction are important auxiliary methods for clinical diagnosis and imaging examination, and are more suitable for clinical use.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R322.121

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本文編號：1425105