發(fā)布時(shí)間：2018-06-01 20:23

  本文選題：入路 + 小腦延髓裂��； 參考：《中國微侵襲神經(jīng)外科雜志》2016年12期

【摘要】：目的通過枕下正中經(jīng)小腦延髓裂鎖孔入路對第四腦室及其周圍結(jié)構(gòu)進(jìn)行顯微解剖觀察,為臨床應(yīng)用提供解剖學(xué)依據(jù)。方法在10具(共20側(cè))成人尸頭標(biāo)本上模擬枕下正中經(jīng)小腦延髓裂鎖孔入路,使用顯微鏡對第四腦室及其周圍組織結(jié)構(gòu)進(jìn)行解剖、觀察和相關(guān)數(shù)據(jù)測定。結(jié)果 (1)枕下正中經(jīng)小腦延髓裂鎖孔入路可暴露第四腦室底、外側(cè)隱窩、中腦導(dǎo)水管開口和腦干側(cè)方等。(2)該入路可暴露的第四腦室底長度(37.73±0.77)mm,寬度(17.12±0.52)mm,面積(319.70±14.25)mm~2。(3)10具尸頭共發(fā)現(xiàn)小腦后下動(dòng)脈(PICA)19側(cè),PICA缺如1側(cè)。同一標(biāo)本雙側(cè)PICA直徑差異較大,PICA下袢位置的變異也較大。結(jié)論 (1)枕下正中經(jīng)小腦延髓裂鎖孔入路對第四腦室的暴露范圍與常規(guī)小腦延髓裂入路相仿,但存在顯露角度受限、深部結(jié)構(gòu)視野不佳等不足。(2)PICA與小腦延髓裂關(guān)系密切,且PICA走行分布復(fù)雜多變,術(shù)中應(yīng)仔細(xì)辨認(rèn),避免誤傷。
[Abstract]:Objective to observe the microanatomy of the fourth ventricle and its surrounding structures through the suboccipital median approach through the keyhole approach of the medulla oblongata so as to provide anatomic basis for clinical application. Methods 10 adult cadaver heads (20 sides) were used to simulate the suboccipital median approach through the keyhole of medulla oblongata. The structure of the fourth ventricle and its surrounding tissues were dissected by microscope and the relevant data were measured. Results 1) the suboccipital median approach via the keyhole of the medullary fissure of the cerebellum exposed the floor of the fourth ventricle and the lateral recess. The length of the floor of the fourth ventricle was 37.73 鹵0.77 mm, the width was 17.12 鹵0.52 mm, and the area was 319.70 鹵14.25)mm~2.(3)10. One side of the posterior inferior cerebellar artery (PICA) was found to be absent in 19 sides of the posterior inferior cerebellar artery. The diameters of PICA in both sides of the same specimen were quite different, and the variation of the position of the lower loop of PICA was also significant. Conclusion (1) the exposure to the fourth ventricle via the median suboccipital approach via the keyhole of the cerebellar fissure is similar to that of the conventional approach, but the exposure angle is limited, and the deep structure of visual field is not good. The PICA is closely related to the cerebellar medullary fissure. Moreover, the distribution of PICA is complex and changeable, so it should be recognized carefully during operation to avoid accidental injury.
【作者單位】： 安徽醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)外科;
【基金】：安徽省科技攻關(guān)項(xiàng)目(編號:12010402113)
【分類號】：R322.8

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本文編號：1965502