枕大孔區(qū)解剖學(xué)變異對(duì)其腹側(cè)病變手術(shù)的指導(dǎo)意義
發(fā)布時(shí)間：2018-10-22 08:38
【摘要】： 目的:對(duì)成人頭顱干性標(biāo)本枕大孔區(qū)的相關(guān)解剖進(jìn)行量化研究,為后外側(cè)入路處理枕大孔腹側(cè)病變手術(shù)中,是否磨除枕髁提供解剖學(xué)依據(jù)。 方法:用游標(biāo)卡尺測(cè)量枕大孔相關(guān)解剖數(shù)據(jù):枕大孔縱徑(FML)、枕大孔橫徑(FMW)、枕大孔前正中點(diǎn)與枕髁后緣連線垂直距離(AOCP),枕髁軸徑(OCA),然后根據(jù)AOCP/FML比值將100例成人頭顱標(biāo)本分為三型(組)。 結(jié)果: FML、FMW、AOCP、OCA分別為34.81±4.39mm、29.11±4.39 mm、15.99±3.25mm、24.07±4.78mm。100例成人頭顱標(biāo)本分為以下三組:I組(小枕髁型)占8%,II組(中枕髁型)占74%,III組(大枕髁型)占18%。 結(jié)論:枕大孔區(qū)解剖結(jié)構(gòu)變異較大。在處理枕大孔腹側(cè)病變前,應(yīng)明確枕大孔區(qū)分型,以選擇合適的后外側(cè)入路。 目的:通過對(duì)成人頭顱標(biāo)本相關(guān)解剖進(jìn)行測(cè)量和量化分析,為下斜坡及枕大孔腹側(cè)病變手術(shù)入路的選擇提供科學(xué)依據(jù)。 方法:根據(jù)枕大孔的AOCP/FML比值將100例成人頭顱標(biāo)本分組,分析每組中采用不同手術(shù)入路時(shí)對(duì)枕大孔腹側(cè)區(qū)顯露角度的差異。 結(jié)果: 100例成人頭顱標(biāo)本分為以下三組:I組(小枕髁型)占8%,II組(中枕髁型)占74%,III組(大枕髁型)占18%。I組中Angle A和Angle B之間無統(tǒng)計(jì)學(xué)差異,但I(xiàn)I、III組中Angle A和Angle B之間存在顯著差異。(angle A and B分別表示磨除枕髁后1/3前后的顯露角度)。 結(jié)論:枕髁大小變異較大,對(duì)于下斜坡及枕大孔腹側(cè)病變,小型枕髁患者術(shù)中無需磨除枕髁,采用枕下外側(cè)入路即可獲得理想的顯露。對(duì)于中、大型枕髁患者,磨除枕髁后可提供更大的觀察視角,因此宜采用經(jīng)髁入路。術(shù)前應(yīng)用螺旋CT行三維骨性重建,明確枕髁類型對(duì)手術(shù)入路的選擇具有指導(dǎo)意義。
[Abstract]:Objective: to quantitatively study the anatomy of occipital foramen region in adult cadaveric cadavers and provide anatomic basis for the treatment of occipital condyle by posterolateral approach in the operation of occipital foramen ventral lesion. Methods: the relative anatomical data of foramen magnum were measured with Vernier caliper: longitudinal diameter of foramen magnum (FML), transverse diameter of foramen magnum (FMW), anterior median point of foramen magnum and posterior edge of occipital condyle vertical distance from axis diameter of (AOCP), occipital condyle (OCA),. The specimens were divided into three types. Results: the FML,FMW,AOCP,OCA was 34.81 鹵4.39mm and 29.11 鹵4.39 mm,15.99 鹵3.25mm 鹵24.07 鹵4.78mm.100 respectively. The head specimens were divided into the following three groups: group I (small occipital condyle) accounted for 8% of the occipital condyle type, and the middle occipital condyle group (middle occipital condyle type) accounted for 18 beats in the 74 occipital condyle group (large occipital condyle type). Conclusion: the anatomical structure of the foramen magnum region has great variation. Before dealing with the ventral occipital foramen, we should identify the type of the foramen magnum and select the appropriate posterolateral approach. Objective: to provide scientific basis for the choice of surgical approach for inferior Clivus and ventral occipital foramen by measuring and quantifying the related anatomy of adult head specimen. Methods: according to the AOCP/FML ratio of the foramen magnum occipitalis, 100 adult cranial specimens were divided into two groups, and the differences of the exposure angles of the ventral occipital foramen were analyzed in each group. Results: one hundred adult cranial specimens were divided into the following three groups: group I (small occipital condyle) accounted for 8% and group II (middle occipital condyle) accounted for 74.The third group (large occipital condyle) accounted for 18.I there was no statistical difference between Angle A and Angle B in group I. But there was significant difference between Angle A and Angle B in II,III group. (angle A and B indicated the exposure angle before and after 1 / 3 of occipital condyle removal. Conclusion: the size of occipital condyle varies greatly. For the inferior Clivus and ventral occipital foramen, the patients with small occipital condyle do not need to grind the occipital condyle during the operation, and the suboccipital lateral approach can obtain the ideal exposure. For medium and large occipital condyle patients, grinding occipital condyle can provide more visual angle, so transcondylar approach is appropriate. Three-dimensional bone reconstruction with spiral CT was performed before operation, and the determination of occipital condyle type was of guiding significance for the choice of operative approach.
【學(xué)位授予單位】：東南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2005
【分類號(hào)】：R322.8;R739.4
本文編號(hào)：2286664
[Abstract]:Objective: to quantitatively study the anatomy of occipital foramen region in adult cadaveric cadavers and provide anatomic basis for the treatment of occipital condyle by posterolateral approach in the operation of occipital foramen ventral lesion. Methods: the relative anatomical data of foramen magnum were measured with Vernier caliper: longitudinal diameter of foramen magnum (FML), transverse diameter of foramen magnum (FMW), anterior median point of foramen magnum and posterior edge of occipital condyle vertical distance from axis diameter of (AOCP), occipital condyle (OCA),. The specimens were divided into three types. Results: the FML,FMW,AOCP,OCA was 34.81 鹵4.39mm and 29.11 鹵4.39 mm,15.99 鹵3.25mm 鹵24.07 鹵4.78mm.100 respectively. The head specimens were divided into the following three groups: group I (small occipital condyle) accounted for 8% of the occipital condyle type, and the middle occipital condyle group (middle occipital condyle type) accounted for 18 beats in the 74 occipital condyle group (large occipital condyle type). Conclusion: the anatomical structure of the foramen magnum region has great variation. Before dealing with the ventral occipital foramen, we should identify the type of the foramen magnum and select the appropriate posterolateral approach. Objective: to provide scientific basis for the choice of surgical approach for inferior Clivus and ventral occipital foramen by measuring and quantifying the related anatomy of adult head specimen. Methods: according to the AOCP/FML ratio of the foramen magnum occipitalis, 100 adult cranial specimens were divided into two groups, and the differences of the exposure angles of the ventral occipital foramen were analyzed in each group. Results: one hundred adult cranial specimens were divided into the following three groups: group I (small occipital condyle) accounted for 8% and group II (middle occipital condyle) accounted for 74.The third group (large occipital condyle) accounted for 18.I there was no statistical difference between Angle A and Angle B in group I. But there was significant difference between Angle A and Angle B in II,III group. (angle A and B indicated the exposure angle before and after 1 / 3 of occipital condyle removal. Conclusion: the size of occipital condyle varies greatly. For the inferior Clivus and ventral occipital foramen, the patients with small occipital condyle do not need to grind the occipital condyle during the operation, and the suboccipital lateral approach can obtain the ideal exposure. For medium and large occipital condyle patients, grinding occipital condyle can provide more visual angle, so transcondylar approach is appropriate. Three-dimensional bone reconstruction with spiral CT was performed before operation, and the determination of occipital condyle type was of guiding significance for the choice of operative approach.
【學(xué)位授予單位】：東南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2005
【分類號(hào)】：R322.8;R739.4
【共引文獻(xiàn)】
相關(guān)碩士學(xué)位論文 前7條
1 郜彩斌;枕下遠(yuǎn)外側(cè)入路中顱外軟組織結(jié)構(gòu)的手術(shù)解剖研究[D];山西醫(yī)科大學(xué);2011年
2 陳鐳;椎動(dòng)脈復(fù)合體的顯微解剖學(xué)研究[D];天津醫(yī)科大學(xué);2002年
3 王永剛;顱底遠(yuǎn)外側(cè)入路的應(yīng)用解剖研究[D];昆明醫(yī)學(xué)院;2003年
4 劉亮;后顱窩遠(yuǎn)外側(cè)手術(shù)入路的顯微外科解剖研究[D];昆明醫(yī)學(xué)院;2004年
5 付旭東;頸靜脈孔區(qū)的顯微解剖學(xué)研究[D];鄭州大學(xué);2006年
6 韓楓;枕下遠(yuǎn)外側(cè)經(jīng)髁手術(shù)入路的顯微解剖學(xué)研究[D];河北醫(yī)科大學(xué);2008年
7 吳進(jìn)松;枕下遠(yuǎn)外側(cè)經(jīng)髁入路的顯微解剖學(xué)定量研究[D];河南科技大學(xué);2008年
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