【摘要】：目的 研究動眼神經(jīng)的走形、長度、外徑、毗鄰結(jié)構(gòu)及血液供應(yīng)，進(jìn)行測量及分析，分段研究了動眼神經(jīng)各區(qū)域的解剖結(jié)構(gòu)，以期對臨床手術(shù)提供解剖學(xué)資料。 方法 取10例福爾馬林固定的成人完整頭顱濕標(biāo)本(男8,女2例)，常規(guī)灌注四根動脈，所有標(biāo)本均頸內(nèi)動脈、椎動脈灌注紅色乳膠，頸內(nèi)靜脈灌注藍(lán)色乳膠。沿眉弓至耳緣連線剝除頭皮,鋸開顱骨,除去顱蓋開顱去除大腦半球,保留腦干大腦腳以下結(jié)構(gòu),在顯微鏡下仔細(xì)解剖巖斜區(qū)、海綿竇及眶頂，顯露動眼神經(jīng)的全程。在10-40倍手術(shù)顯微鏡下進(jìn)行仔細(xì)測量，并結(jié)合解剖學(xué)資料對比分析，所得的數(shù)據(jù)采用SPSS10.0進(jìn)行數(shù)據(jù)處理,數(shù)據(jù)以x±s表示,行t檢驗。 結(jié)果 動眼神經(jīng)距離后床突5.13±1.26mm，動眼神經(jīng)與后交通動脈距離為9.72±2.13mm，動眼神經(jīng)小腦幕入口與滑車神經(jīng)入口距離為10.20±2.71mm，動眼神經(jīng)在小腦幕緣下方距滑車神經(jīng)距離為2.84±0.22mm，動眼神經(jīng)小腦幕入口與滑車神經(jīng)入口距離為10.20±2.71mm，動眼神經(jīng)三角入口中點距前床突距離為7.47±0.32mm，距離后床突距離為6.25±0.30mm，距巖尖距離為9.32±0.33mm。 動眼神經(jīng)從起始部運行至后巖床皺襞距離為15.2±2.2mm，經(jīng)后巖床皺襞至入海綿竇距離為5.12±0.80mm，動眼神經(jīng)池長度為7.20±1.62mm，動眼神經(jīng)距離前床突為2.42±0.43mm，動眼神經(jīng)經(jīng)海綿竇距離為15.2±1.14mm。 動眼神經(jīng)上支橫徑1.23±0.57mm，下支橫徑1.60±0.23mm，動眼神經(jīng)起始部至上下支平均直徑為2.4±0.3mm。 結(jié)論 動眼神經(jīng)在顱內(nèi)行程長，走形復(fù)雜，顱內(nèi)多種病變時動眼神經(jīng)均可受累。臨床神經(jīng)外科醫(yī)生在處理這些區(qū)域病變時，應(yīng)仔細(xì)分離，，小心牽拉以免損傷動眼神經(jīng)供血動脈，熟悉的顯微解剖知識以及嫻熟的顯微神經(jīng)外科技術(shù)與手術(shù)技巧是減少動眼神經(jīng)損傷的必要條件。
[Abstract]:Objective to study the shape, length, outer diameter, adjacent structure and blood supply of oculomotor nerve, to measure and analyze the anatomical structure of oculomotor nerve, and to study the anatomical structure of oculomotor nerve in order to provide anatomical data for clinical operation. Methods Ten complete adult head wet specimens (male 8, female 2) fixed with formalin were routinely perfused with four arteries. All specimens were perfused with red latex into vertebral artery and blue latex in internal jugular vein. The scalp was removed from the eyebrow arch to the ear margin, the skull was sawed, the skull cover was removed, the cerebral hemisphere was removed, the structure below the foot of the brain stem was preserved, and the petroclival area, cavernous sinus and orbital apex were carefully dissected under microscope to reveal the whole course of oculomotor nerve. The data were carefully measured under 10 脳 40 times operation microscope and compared with anatomical data. The data were processed by SPSS10.0, and the data were expressed by x 鹵s and t test. Results the distance of oculomotor nerve from posterior clinoid process was 5.13 鹵1.26mm, the distance between oculomotor nerve and posterior communicating artery was 9.72 鹵2.13mm, the distance between the entrance of oculomotor nerve cerebellar nerve and the entrance of pulley nerve was 10.20 鹵2.71mm, the distance between oculomotor nerve below the tentorial margin of cerebellum was 2.84 鹵0.22mm, and the distance between the entrance of oculomotor nerve and the entrance of troute nerve was 10.20 鹵2.71mm. The distance from the middle point of oculomotor nerve triangle to the anterior clinoid process was 7.47 鹵0.32 mm, to the posterior clinoid process was 6.25 鹵0.30 mm, and to the petrosal tip was 9.32 鹵0.33 mm. The distance from the origin of oculomotor nerve to posterior petrous bed fold was 15.2 鹵2.2 mm, the distance from posterior petrous bed fold to cavernous sinus was 5.12 鹵0.80 mm, the length of oculomotor nerve pool was 7.20 鹵1.62 mm, the distance of oculomotor nerve from anterior clinoid process was 2.42 鹵0.43 mm, and the distance of oculomotor nerve via cavernous sinus was 15.2 鹵1.14 mm. The transverse diameter of the superior branch of the oculomotor nerve was 1.23 鹵0.57 mm, and the transverse diameter of the lower branch was 1.60 鹵0.23 mm. The average diameter from the origin of the oculomotor nerve to the upper and lower branches of the oculomotor nerve was 2.4 鹵0.3 mm. Conclusion the oculomotor nerve can be involved in all kinds of intracranial lesions because of its long stroke and complex appearance. When dealing with these regional lesions, clinical neurosurgeons should carefully separate, carefully pull to avoid injury of oculomotor nerve blood supply artery, familiar microanatomy knowledge and skilled microsurgical techniques and surgical skills are the necessary conditions to reduce oculomotor nerve injury.
【學(xué)位授予單位】：遼寧醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R322.85

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