本文選題：小腦幕切跡前間隙 + 腦池��； 參考：《吉林大學(xué)》2007年博士論文

【摘要】： 小腦幕切跡前間隙是神經(jīng)外科解剖構(gòu)成非常復(fù)雜的區(qū)域,同時也是顱內(nèi)腫瘤的高發(fā)區(qū)域之一。由于小腦幕切跡前間隙的解剖復(fù)雜性以及病變的不同走向和生物學(xué)特性,決定了對此間隙精細(xì)顯微解剖的理解和掌握以及針對不同病變采取相應(yīng)的手術(shù)入路是有效的完成手術(shù)、減少術(shù)后并發(fā)癥的關(guān)鍵。雖然當(dāng)前對此間隙的顯微解剖及手術(shù)入路已有較為深入的研究,但仍有一些精細(xì)的解剖構(gòu)成和手術(shù)入路的拓展方面尚需進一步探討研究以滿足臨床需要。 本實驗對10例尸頭標(biāo)本通過逐步切除腦組織,對小腦幕切跡前間隙進行系統(tǒng)的的顯微解剖學(xué)觀察,為臨床提供相關(guān)的解剖學(xué)數(shù)據(jù);對6例尸頭標(biāo)本分別模擬與小腦幕切跡前間隙相關(guān)較為常用的手術(shù)入路,為臨床在手術(shù)入路選擇的規(guī)范性和手術(shù)操作的安全性上提供參考。通過上述實驗,本文提出如下創(chuàng)新:①將起始于蝶棱和鐮狀皺襞連線處向后延伸構(gòu)成視交叉池上層蛛網(wǎng)膜和嗅池后部蛛網(wǎng)膜的蛛網(wǎng)膜結(jié)構(gòu)命名前顱底上層蛛網(wǎng)膜,后者有助于對切跡前間隙腦池空間構(gòu)成的理解與掌握;②提出利用動眼神經(jīng)門后緣作為鞍旁區(qū)與上巖斜區(qū)的大體解剖分界標(biāo)志;③將垂體柄上部與視交叉之間的錐形空間命名為垂體柄上前間隙,后者可為切除鞍區(qū)病變時保護下丘腦-垂體柄和視力功能提供解剖支持;④在硬膜外將巖尖內(nèi)側(cè)三角磨除,可進一步擴大顳下巖骨前入路的術(shù)野顯露,為小腦幕切跡前間隙后部病變的切除提供了更為廣闊的手術(shù)空間。
[Abstract]:The anterior space of tentorial incisor is a very complicated area in neurosurgical anatomy, and it is also one of the high incidence areas of intracranial tumors.Due to the anatomical complexity of the anterior tentorial notch space and the different trends and biological characteristics of the lesions, the understanding and mastering of the fine microanatomy of the space and the corresponding operative approach to the different lesions are effective in completing the operation.The key to reduce postoperative complications.Although the microanatomy and operative approach of this space have been studied deeply at present, there are still some fine anatomical components and the expansion of the operative approach which need to be further studied to meet the clinical needs.In this experiment, 10 cadaveric head specimens were subjected to systematic microanatomical observation of the anterior space of cerebellar tentorial incisors by gradual excision of brain tissue, which provided relevant anatomical data for clinical practice.Six cadaveric cadaveric specimens were used to simulate the common operative approaches associated with the anterior space of cerebellar tentorial incisors, which provided a reference for the selection of operative approaches and the safety of surgical procedures.Based on the above experiments, this paper proposes the following innovation: 1: 1 to form the arachnoid structure of the anterior skull base of the upper arachnoid layer of the optic chiasma cistern and the posterior part of the olfactory cistern by extending backward from the line between the sphenoid ridge and the sickle fold.The latter is helpful in understanding and mastering the spatial composition of the cisterns in the prenotch space. 2 the posterior margin of the oculomotor hilus is used as a gross anatomic boundary marker between the parasellar region and the superior petrosal oblique area.(3) the conical space between the upper part of the pituitary stalk and the optic chiasma was named as the anterior space of the pituitary stalk. The latter could provide anatomical support for the protection of hypothalamus-pituitary stalk and visual function in the excision of the lesions in the Sellar region.It can further expand the exposure of the surgical field through the anterior approach of the infratemporal petrosal bone and provide a wider surgical space for the resection of the posterior lesions of the anterior tentorial notch of the cerebellum.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2007
【分類號】：R651.1;R322

【參考文獻】

相關(guān)期刊論文 前10條

1 呂衡發(fā)，高嵩，蘇略;大腦中動脈的顯微解剖及其臨床意義[J];白求恩醫(yī)科大學(xué)學(xué)報;1995年01期

2 張義泉,王衛(wèi)紅,馮春國,李長元;翼點入路顯微手術(shù)切除前中顱底病變[J];中華神經(jīng)醫(yī)學(xué)雜志;2004年03期

3 吳喜躍,何理盛,康德智,陳陸馗;顱中窩底硬膜外入路技術(shù)改進及相關(guān)解剖學(xué)[J];福建醫(yī)科大學(xué)學(xué)報;2003年01期

4 駱成,李監(jiān)松,常莎,魏文洲;中顱窩孔道的CT研究及臨床評價[J];海南醫(yī)學(xué)院學(xué)報;1999年03期

5 王玉海!214044江蘇無錫,蔡學(xué)見!214044江蘇無錫,盧亦成!200003上海;Labbe靜脈的顯微解剖及其臨床意義[J];國外醫(yī)學(xué).腦血管疾病分冊;2001年04期

6 劉宏毅;鄒元杰;張巖松;常義;張銳;呂著海;劉翔;;頸內(nèi)動脈分叉上間隙的解剖及其在鞍區(qū)大型腫瘤手術(shù)中的應(yīng)用[J];南京醫(yī)科大學(xué)學(xué)報(自然科學(xué)版);2006年06期

7 伍洪昊,萬麗丹,萬衛(wèi),李美華;顳下經(jīng)巖骨前部入路的臨床應(yīng)用解剖學(xué)研究[J];江西醫(yī)藥;2004年02期

8 鐵欣昕,王欣,王運杰;經(jīng)翼點入路鞍區(qū)手術(shù)間隙解剖學(xué)研究[J];解剖科學(xué)進展;2004年02期

9 朱國臣,婁衛(wèi)華,孫永強,黃新輝,韓云志,袁林林;頸內(nèi)動脈巖內(nèi)段的顯微解剖[J];解剖學(xué)雜志;2004年05期

10 黎國雄,趙洪洋,吳江,甄云,周育瑾;天幕裂孔區(qū)的應(yīng)用解剖[J];解剖學(xué)雜志;2005年05期

，

本文編號：1748364