本文關(guān)鍵詞：鼻部血管的應(yīng)用解剖及臨床意義　出處：《山東大學(xué)》2009年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 鼻部血管 鼻外側(cè)動脈 面動脈

【摘要】： 研究背景鼻部是面部的重要器官,是面部美容的重要結(jié)構(gòu)。鼻部的手術(shù)不單單是去除病變組織,恢復(fù)功能,更需要注重鼻部外形的修復(fù)和美觀。臨床上對鼻部缺損的修復(fù)做了很多研究,提出了許多方式和方法。近年來顯微外科的迅速發(fā)展為鼻部缺損的修復(fù)和重建創(chuàng)造了良好條件。已有多例斷鼻再植成功的報道。但臨床上對鼻部血管走行的研究還不十分透徹,這導(dǎo)致了一些鼻部手術(shù)的失敗。本文就近年來面動脈主要血管區(qū)域的應(yīng)用解剖學(xué)研究作一綜述,并著重研究鼻部皮膚血管的來源、走行及與周圍血管的交通情況,為鼻部缺損的修復(fù)及斷鼻再植的血管供應(yīng)提供解剖學(xué)基礎(chǔ)。 目的解剖鼻部血管并觀察鼻部血管的走行規(guī)律和變異情況 方法 采用頸動脈乳膠灌注的方法對10例標本進行灌注并解剖,觀察鼻部的血管走行情況并測量實驗數(shù)據(jù)。總結(jié)鼻部血管的走行規(guī)律。 結(jié)果 鼻部皮膚的血管走行特點 (1)鼻軟骨部的血管多走行于軟骨內(nèi)。鼻部皮膚的血供主要來自兩側(cè)面動脈發(fā)出上唇動脈后繼續(xù)向上延續(xù)而成鼻外側(cè)動脈。鼻外側(cè)動脈約在鼻翼角水平發(fā)出鼻底支供應(yīng)鼻底皮膚和鼻粘膜。而后其主干繼續(xù)向上約在鼻骨與鼻軟骨交界處發(fā)出鼻翼支供應(yīng)鼻部皮膚并與來自對側(cè)的分支相交通,該分支沿途發(fā)出許多細小的分支分別供應(yīng)鼻軟骨部的皮膚和鼻粘膜,是鼻軟骨部皮膚血供的主要來源。 (2)鼻翼動脈多是鼻外側(cè)動脈在鼻骨與鼻軟骨交界處和鼻翼角之間發(fā)出鼻翼支,極少數(shù)標本由眼動脈的終末支鼻背動脈發(fā)出,該動脈在鼻翼向?qū)?cè)走行并與對側(cè)鼻翼動脈吻合形成一條動脈弓。在多數(shù)標本上該弓由優(yōu)勢側(cè)鼻外側(cè)動脈發(fā)出橫跨鼻翼至對側(cè)鼻外側(cè)動脈的分支形成。該弓沿途發(fā)出許多細小的分支分別供應(yīng)鼻軟骨部的皮膚和鼻粘膜,并與鼻小柱動脈交通,是鼻軟骨部皮膚血供的主要來源。 (3)雙側(cè)鼻翼動脈通過鼻中柱動脈與雙側(cè)上唇動脈的鼻底部交通支相連構(gòu)成兩個圍繞鼻兩側(cè)鼻翼的環(huán)狀結(jié)構(gòu)。當一側(cè)面動脈受損時,可以經(jīng)此結(jié)構(gòu)由對側(cè)代償供血。 (4)鼻部血管的變異情況在解剖過程中發(fā)現(xiàn)鼻部血管走行存在較大變異。10具尸體共20側(cè)面動脈有5側(cè)(均為左側(cè))鼻外側(cè)動脈缺如,缺如側(cè)的血供由對側(cè)和眼動脈穿出內(nèi)眥向下的終末支提供。兩側(cè)鼻外側(cè)動脈的的管徑也有較大差異,其中右側(cè)優(yōu)勢者占多數(shù)(70%)。 結(jié)論鼻部的血供大多數(shù)來自鼻外側(cè)動脈或內(nèi)眥動脈。鼻翼皮膚存在連接兩側(cè)鼻外側(cè)動脈的動脈弓。雙側(cè)鼻翼的動脈通過鼻中柱動脈與雙側(cè)上唇動脈的鼻底部交通支相連構(gòu)成兩個圍繞鼻兩側(cè)鼻翼的環(huán)狀結(jié)構(gòu)。當一側(cè)面動脈受損時,可以經(jīng)此結(jié)構(gòu)由對側(cè)代償供血。
[Abstract]:Background nose is an important organ of the face and an important structure of facial beauty. Nasal surgery is not only to remove pathological tissue and restore function. More need to pay attention to the shape of the nose and beauty. Clinical repair of nasal defects have done a lot of research. In recent years, the rapid development of microsurgery has created good conditions for the repair and reconstruction of nasal defects. Many successful cases of nasal replantation have been reported. Not very thorough. This has led to the failure of some nasal surgery. This article reviews the applied anatomy of the main vascular regions of the facial artery in recent years, and focuses on the origin of the nasal skin vessels. The walking and communicating with the surrounding vessels provide anatomic basis for the repair of nasal defects and the supply of blood vessels for the replantation of broken nose. Objective to dissect nasal vessels and observe the regularity and variation of nasal vessels Method Ten specimens were perfused and dissected by the method of carotid latex perfusion. The blood vessels of the nasal region were observed and the experimental data were measured. Results The characteristics of nasal skin vascularity 1). The blood supply of nasal skin mainly comes from the upper labial artery of the two sides and then continues upward to form the lateral nasal artery. The lateral nasal artery sends out the nasal fundus about at the level of the alar angle. The trunk continues to supply the nasal skin at the junction between the nasal bone and the nasal cartilage and communicates with the branches from the contralateral side. Many small branches along the way supply the skin of nasal cartilage and nasal mucosa respectively, which is the main source of skin blood supply in nasal cartilage. (2) most of the alar artery is the lateral nasal artery which sends out the alar branch between the nasal bone and the nasal cartilage and the angle of the alar, and a few specimens are from the nasal dorsal artery, which is the final branch of the ophthalmic artery. The artery travels contralateral through the nasal wing and anastomoses with the contralateral alar artery to form an arterial arch. In most specimens, the arch is formed by a branch of the dominant lateral nasal artery across the nasal wing to the contralateral nasal artery. The arch is along the way. It emits many small branches that supply the skin and nasal mucosa of the nasal cartilage, respectively. The arterial communication with nasal column is the main source of skin blood supply in nasal cartilage. 3) the bilateral alar artery is connected to the nasal bottom communicating branch of bilateral upper lip artery through the middle column artery of the nose to form two annular structures surrounding both sides of the nose, when one side artery is damaged. The blood supply may be compensated by the contralateral structure. In the course of dissection, there was a great variation in the route of nasal vessels. There were 10 cadavers with 20 lateral arteries and 5 (all left) lateral nasal arteries were absent. The blood supply of the absent side was provided by the contralateral and ophthalmic arteries passing through the terminal branches down the medial canthus. The diameter of bilateral lateral nasal arteries was also different. Conclusion most of the nasal blood supply comes from the lateral nasal artery or the medial canthus artery. The alar skin has an arterial arch connecting the bilateral lateral nasal artery. The bilateral alar artery passes through the middle nasal column artery and the bilateral upper lip artery to the bottom of the nose. The connecting branches form two annular structures surrounding the nasal wings. When a lateral artery is damaged. The blood supply may be compensated by the contralateral structure.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2009
【分類號】：R322

【參考文獻】

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1 陳江萍,邢新,楊志勇,孫q，

本文編號：1373123