本文關(guān)鍵詞： 前縱裂入路 前交通動(dòng)脈 解剖　出處：《桂林醫(yī)學(xué)院》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：模擬雙額冠狀切口經(jīng)單額開顱前縱裂入路,對(duì)此入路中涉及的部分解剖因素、前交通動(dòng)脈復(fù)合體及其周圍毗鄰結(jié)構(gòu)進(jìn)行解剖觀察記錄及數(shù)據(jù)測(cè)量,討論經(jīng)前縱裂入路對(duì)前交通動(dòng)脈復(fù)合體的暴露過程中需要注意的因素,對(duì)經(jīng)前縱裂入路手術(shù)特別是需涉及前交通動(dòng)脈復(fù)合體的手術(shù)提供解剖依據(jù)。方法：1.0%甲醛充分固定的國(guó)人成人帶頸尸頭濕標(biāo)本15例經(jīng)紅藍(lán)乳膠灌注染色、去除異味、軟化、漂白后模擬雙額冠狀切口經(jīng)單額開顱前縱裂入路,測(cè)量前交通動(dòng)脈復(fù)合體最大可顯露路徑與顱底長(zhǎng)軸夾角,以游標(biāo)卡尺測(cè)量鼻根點(diǎn)處顱骨外緣至前交通動(dòng)脈最近點(diǎn)距離、前交通動(dòng)脈復(fù)合體最大可顯露路徑假想線與額極交點(diǎn)距鼻根點(diǎn)的距離、前交通動(dòng)脈的支數(shù),以及它們發(fā)出內(nèi)穿支動(dòng)脈及回返動(dòng)脈數(shù)目,并在顯微鏡下觀察間隙內(nèi)的血管、神經(jīng),對(duì)血管的各種形態(tài)、走行及變異進(jìn)行記錄并拍照。結(jié)果：經(jīng)前縱裂入路對(duì)前交通動(dòng)脈復(fù)合體的暴露過程中前交通動(dòng)脈復(fù)合體最大可顯露路徑與顱底長(zhǎng)軸夾角為15.36-28.54°,鼻根點(diǎn)處顱骨外緣至前交通動(dòng)脈最近點(diǎn)距離為48.52-58.86mm,前交通動(dòng)脈復(fù)合體最大可顯露路徑假想線與額極交點(diǎn)距鼻根點(diǎn)的距離為31.48-54.26mm,均值分別為22.45°、53.35 mm、40.23 mm,前交通動(dòng)脈復(fù)合體數(shù)據(jù)與參考文獻(xiàn)無明顯差異,未見明顯解剖變異情況。結(jié)論：經(jīng)前縱裂入路手術(shù)特別是需涉及需要暴露前交通動(dòng)脈復(fù)合體的手術(shù)如前交通動(dòng)脈及胼周動(dòng)脈動(dòng)脈瘤夾閉術(shù)、三腦室前部顱咽管瘤、鞍上發(fā)展明顯頂部較高的垂體瘤及其他腫瘤的摘除術(shù)需注意骨瓣大小、手術(shù)目的暴露的合適角度、手術(shù)入路深度及前交通動(dòng)脈、回返動(dòng)脈、前交通動(dòng)脈復(fù)合體穿支動(dòng)脈的正常及變異情況等,本實(shí)驗(yàn)研究可為其提供部分?jǐn)?shù)據(jù)參考依據(jù)。
[Abstract]:Objective: to simulate the bilateral frontal coronal incision through the single frontal anterior longitudinal fissure approach, and to observe and measure the anatomical factors involved in the approach, the anterior communicating artery complex and its adjacent structures. The factors needing attention in the exposure of anterior communicating artery complex through anterior longitudinal fissure approach were discussed. Methods: to provide anatomic basis for anterior longitudinal fissure operation, especially for the operation involving anterior communicating artery complex. 1.0% 15 wet specimens of Chinese adults with necked cadavers were stained with red and blue latex. After bleaching, the double frontal coronal incision was simulated through the single frontal anterior longitudinal fissure approach, and the maximum exposure path of the anterior communicating artery complex and the angle between the long axis of the skull base and the anterior communicating artery complex were measured. Vernier caliper was used to measure the distance from the outer margin of the skull at the nasal root point to the nearest point of the anterior communicating artery, the distance between the imaginary line of the anterior communicating artery and the intersection point of the frontal pole and the nasal root point, and the number of branches of the anterior communicating artery. And the number of internal perforating arteries and return arteries, and observe the vessels and nerves in the interspace under the microscope, and the various forms of the vessels. Record and photograph walking and variation. Results:. During the exposure of the anterior communicating artery complex through the anterior longitudinal fissure approach, the angle between the maximum exposure path of the anterior communicating artery complex and the long axis of the skull base was 15.36-28.54 擄. The distance from the outer margin of skull to the nearest point of anterior communicating artery was 48.52-58.86mm. The distance between the maximum exposure path of the anterior communicating artery complex and the intersection of the frontal pole and the nasal root was 31.48-54.26mm, and the mean value was 22.45 擄/ 53.35 mm, respectively. 40.23 mm. There was no significant difference between the data of anterior communicating artery complex and references. Conclusion: the anterior longitudinal fissure approach is necessary to expose the anterior communicating artery complex, such as anterior communicating artery and pericallosal artery aneurysm. For craniopharyngioma of the anterior part of the third ventricle, the size of bone flap, the appropriate angle of exposure, the depth of operation approach and the anterior communicating artery should be paid attention to in the excision of pituitary tumor and other tumors with obvious apical top of suprasellar development. The normal and variation of recurrent artery, anterior communicating artery complex perforating artery, etc., this study can provide some reference data for it.
【學(xué)位授予單位】：桂林醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R322;R651.1

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