本文選題：側(cè)腦室 + 鎖孔神經(jīng)外科�。� 參考：《蘇州大學》2005年博士論文

【摘要】：第一部分神經(jīng)導航輔助經(jīng)胼胝體側(cè)腦室鎖孔入路的解剖學研究 目的:探索經(jīng)胼胝體側(cè)腦室鎖孔入路的可行性;研究該鎖孔入路的手術(shù)顯露和相關(guān)解剖因素在手術(shù)暴露中的作用;探討經(jīng)胼胝體側(cè)腦室鎖孔入路的設(shè)計原則和方法。 方法:選用16 例經(jīng)彩色乳膠血管灌注的正常成年國人尸頭,神經(jīng)導航輔助下模擬經(jīng)胼胝體側(cè)腦室鎖孔入路手術(shù),觀測各鎖孔入路對側(cè)腦室的手術(shù)暴露范圍,測量入路相關(guān)解剖結(jié)構(gòu),以矢狀位術(shù)野角和冠狀位術(shù)野角為評價指標,運用SPSS10.0 軟件統(tǒng)計分析。設(shè)計出至各解剖區(qū)域的經(jīng)胼胝體側(cè)腦室鎖孔入路。 結(jié)果:神經(jīng)導航輔助下能準確地完成經(jīng)胼胝體側(cè)腦室鎖孔入路手術(shù)。經(jīng)胼胝體側(cè)腦室鎖孔入路手術(shù)中,影響矢狀位術(shù)野角的主要解剖因素有骨窗長度(r=0.462)、胼胝體切口長度(r=-0.185)、骨窗-胼胝體切口間距(r=-0.300)、同側(cè)/對側(cè)骨窗入路(r=0.206)、胼胝體切口位置角(代表胼胝體切口與室間孔的相對位置,r=-0.119)、骨窗-胼胝體切口相對位置角(r=0.263);影響冠狀位術(shù)野角的相關(guān)因素是胼胝體切口長度(r=0.158)、骨窗-胼胝體切口間距(r=0.523)、同側(cè)/對側(cè)骨窗入路(r=0.162)、胼胝體切口位置角(r=-0.197)和骨窗-胼胝體切口相對位置角(r=-0.175)。數(shù)據(jù)回歸分析獲得矢狀位和冠狀位術(shù)野角回歸方程。A-Ⅰ、M-Ⅱ、M-Ⅰ、P-Ⅱ和P-Ⅰ鎖孔入路都能暴露到額角,其中A-Ⅰ和M-Ⅱ鎖孔入路僅能暴露額角后部,P-Ⅱ和P-Ⅰ鎖孔入路可暴露額角尖。A-Ⅱ、M-Ⅱ、M-Ⅲ和P-Ⅲ鎖孔入路能暴露整個體部,A-Ⅰ和P-Ⅱ入路只能暴露體部的前半、A-Ⅲ入路可暴露體部的后半。A-Ⅱ、A-Ⅲ、M-Ⅲ和P-Ⅲ鎖孔入路能暴露房部,其中P-Ⅲ僅能暴露房部前內(nèi)側(cè)部,A-Ⅱ和M-Ⅲ入路對房部內(nèi)側(cè)半暴露較好,A-Ⅲ入路可暴露到枕角。 結(jié)論:實驗設(shè)計的矢狀位和冠狀位術(shù)野角可客觀評價經(jīng)胼胝體側(cè)腦室鎖孔入路的暴露水平,有助于理解和把握影響手術(shù)暴露的眾多解剖因素。設(shè)計的經(jīng)胼胝體側(cè)腦室鎖孔入路能夠完成側(cè)腦室額角、體部、房部和枕角的手術(shù)暴露。
[Abstract]:Part I Anatomical study of neuronavigation assisted transcallosal approach to the keyhole of the lateral ventricle of the corpus callosum Objective: to explore the feasibility of the transcallosal approach to the lateral ventricle keyhole, to study the role of the operative exposure and related anatomical factors of the keyhole approach, and to explore the design principles and methods of the transcallosal lateral ventricular keyhole approach. Methods: sixteen cadaveric heads of normal adult Chinese were perfused with color latex blood vessels. The operation was simulated through the keyhole approach of corpus callosum lateral ventricle assisted by neuronavigation. The operative exposure range of each keyhole approach to the contralateral ventricle was observed. The anatomical structure of the approach was measured. The sagittal angle and coronal angle of the surgical field were used as the evaluation index, and the statistical analysis was made by SPSS10.0 software. A transcallosal approach to the lateral ventricle keyhole of the corpus callosum was designed for each anatomic region. Results: the transcallosal lateral ventricle keyhole approach can be performed accurately with neuronavigation. Transcallosal lateral ventricular keyhole approach, The main anatomical factors affecting the sagittal angle of the surgical field are the length of bone window 0.462n, the length of corpus callosum incision r-0.185, the distance between bone window and corpus callosum incision r-0.300, the ipsilateral / contralateral osseous window approach, the position angle of corpus callosum incision (representing the incision of corpus callosum and the interventricular foramen), and the position angle of corpus callosum incision (representing the incision of corpus callosum and interventricular foramen). The relative position of bone window and corpus callosum incision was 0.263. The related factors affecting the coronal position were the length of corpus callosum incision, the interval between bone window and corpus callosum, the ipsilateral / contralateral osseous window approach, and the position of corpus callosum incision. The relative position of the bone window and corpus callosum incision was 0.175. Data regression analysis showed that sagittal and coronal field angle regression equation. A- 鈪，

本文編號：1955463