本文選題：上矢狀竇 + 內(nèi)窺鏡�。� 參考：《山東大學(xué)》2006年碩士論文

【摘要】：目的：研究上矢狀竇的大體及顯微解剖，研究上矢狀竇的靜脈回流、與其他靜脈竇的連通，上矢狀竇腔內(nèi)纖維索結(jié)構(gòu)、蛛網(wǎng)膜顆粒及竇匯區(qū)的內(nèi)窺鏡解剖，竇匯區(qū)分流優(yōu)勢(shì)方向的臨床意義。 方法：5具成人頭顱標(biāo)本，去除顱蓋，，觀察上矢狀竇的大體解剖、靜脈屬支、與其他靜脈的交通及竇匯處回流方向。應(yīng)用內(nèi)窺鏡研究竇腔內(nèi)纖維索結(jié)構(gòu)、蛛網(wǎng)膜顆粒及竇匯區(qū)的原始結(jié)構(gòu)特征；并縱行剖開管腔，顯微鏡下觀察纖維索、蛛網(wǎng)膜顆粒及竇匯區(qū)解剖。65張DSA造影片選擇充盈最佳的靜脈竇期片，側(cè)位像觀察上矢狀竇與與其他靜脈竇的連通，正位像觀察竇匯區(qū)上矢狀竇分流方向及腦皮質(zhì)表面觀察大腦上、中、下靜脈的吻合連通。最后于蛛網(wǎng)膜顆粒及板層狀纖維索處作病理切片觀察細(xì)微結(jié)構(gòu)。 結(jié)果：上矢狀竇收集額頂枕葉外側(cè)面上部及內(nèi)側(cè)面上部，額葉下表面前部的靜脈血。前段接受額極靜脈、額前靜脈和額中靜脈；上矢狀竇中段接受額后靜脈、中央前靜脈、中央靜脈、中央后靜脈和頂前靜脈；上矢狀竇后段接受頂后靜脈和枕靜脈。不同皮質(zhì)區(qū)域的靜脈匯入SSS形成特征性格局。起自額葉前部附近的靜脈在其與矢狀竇接頭處向后走行，與竇內(nèi)血流方向相同。起自額葉后半部分的靜脈近乎直角匯入上矢狀竇。頂葉和枕葉的靜脈末端匯入SSS角度與與竇內(nèi)血流方向相反。靜脈匯入上矢狀竇方向由前段的與竇內(nèi)血流方向相同向中后段的與竇內(nèi)血流方向相反逐漸移行。大腦上、中靜脈間的吻合，使上矢狀竇先與大腦中淺靜脈相連通，由于后者的末端達(dá)大腦半球的底面后注入海綿竇、蝶頂竇和巖上竇，所以上矢狀竇又借助大腦中淺靜脈與上述硬腦膜靜脈竇構(gòu)成了吻合；上矢狀竇通過大腦上、下靜脈間的吻合和大腦上、中、下靜脈間的吻合與橫竇之間構(gòu)成了直接吻合；又先通過大腦上、中靜脈間的吻合，繼之通過大腦中、下靜脈間的吻合與橫竇之間構(gòu)成了間接吻合。存在于大腦鐮中與上矢狀竇有關(guān)的吻合靜脈使上矢狀竇與下矢狀竇、與直竇之間構(gòu)成了直接吻合。內(nèi)窺鏡下觀察上矢狀竇管腔內(nèi)纖
[Abstract]:Objective: to study the gross and microscopic anatomy of the superior sagittal sinus, the venous drainage of the superior sagittal sinus, the connection between the superior sagittal sinus and other venous sinuses, the structure of the fibrous cord in the superior sagittal sinus, the endoscopic anatomy of the arachnoid granules and the confluence area of the sinus. Clinical significance of shunt dominance in sinus confluence. Methods the cranial cap was removed from 5 adult head specimens and the gross anatomy of the superior sagittal sinus was observed. The branches of the veins were observed and the flow direction of the superior sagittal sinus was observed. The structure of fiber cord, arachnoid granules and sinusoidal confluence were studied by endoscope, the fibers were dissected longitudinally, and the fibers were observed under microscope. Anatomy of arachnoid granules and sinus confluence. 65 DSA films were selected for filling the best venous sinus films. Lateral images were used to observe the connection between the superior sagittal sinus and other venous sinuses. The direction of the superior sagittal sinus shunt in the confluence area and the surface of the cerebral cortex were observed. Finally, the fine structures of arachnoid granules and lamellar fibers were observed. Results: the venous blood was collected from the superior part of the lateral and medial occipital lobe of the frontal parietal lobe and the anterior part of the inferior frontal surface of the superior sagittal sinus. The anterior segment received the frontal polar vein, the anterior frontal vein and the middle frontal vein; the middle segment of the superior sagittal sinus received the posterior frontal vein, the precentral vein, the posterior central vein and the anterior parietal vein; the posterior parietal vein and the occipital vein were accepted in the posterior segment of the superior sagittal sinus. The venous influx of SSS in different cortical regions formed a characteristic pattern. The vein from the prefrontal lobe runs backward at the junction with the sagittal sinus, the same direction as the blood flow in the sinus. The veins from the posterior part of the frontal lobe converge almost at right angles into the superior sagittal sinus. The SSS angle at the end of the vein in the parietal and occipital lobes is opposite to that in the sinus. The direction of the vein flowing into the superior sagittal sinus changed gradually from the direction of the anterior segment and the direction of the blood flow in the sinus to the direction of the blood flow in the middle and posterior part of the sinus. The superior sagittal sinus is connected to the superficial cerebral vein by the anastomosis of the superior and middle veins, because the end of the latter reaches the bottom of the cerebral hemisphere and then infuses the cavernous sinus, the sphenoid apex sinus and the superior petrosal sinus. So the superior sagittal sinus is anastomosed with the dural sinus with the aid of the superficial cerebral vein, and the superior sagittal sinus is anastomosed through the superior, inferior and superior cerebral veins, and the anastomosis between the middle and inferior veins forms a direct anastomosis between the transverse sinus and the superior sagittal sinus. The anastomosis of the inferior vein and the transverse sinus is formed by the anastomosis of the superior cerebral vein and the middle vein, followed by the indirect anastomosis between the inferior vein and the transverse sinus. The anastomotic veins associated with the superior sagittal sinus in the falx make the superior sagittal sinus, the inferior sagittal sinus, and the straight sinus a direct anastomosis between the superior sagittal sinus and the inferior sagittal sinus. Endoscopy of the superior sagittal sinus
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R651.1;R322

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