前纵裂入路对前交通动脉复合体解剖研究

发布时间：2018-01-30 09:14

本文关键词： 前纵裂入路前交通动脉解剖　出处：《桂林医学院》2011年硕士论文　论文类型：学位论文

【摘要】：目的：模拟双额冠状切口经单额开颅前纵裂入路,对此入路中涉及的部分解剖因素、前交通动脉复合体及其周围毗邻结构进行解剖观察记录及数据测量,讨论经前纵裂入路对前交通动脉复合体的暴露过程中需要注意的因素,对经前纵裂入路手术特别是需涉及前交通动脉复合体的手术提供解剖依据。方法：1.0%甲醛充分固定的国人成人带颈尸头湿标本15例经红蓝乳胶灌注染色、去除异味、软化、漂白后模拟双额冠状切口经单额开颅前纵裂入路,测量前交通动脉复合体最大可显露路径与颅底长轴夹角,以游标卡尺测量鼻根点处颅骨外缘至前交通动脉最近点距离、前交通动脉复合体最大可显露路径假想线与额极交点距鼻根点的距离、前交通动脉的支数,以及它们发出内穿支动脉及回返动脉数目,并在显微镜下观察间隙内的血管、神经,对血管的各种形态、走行及变异进行记录并拍照。结果：经前纵裂入路对前交通动脉复合体的暴露过程中前交通动脉复合体最大可显露路径与颅底长轴夹角为15.36-28.54°,鼻根点处颅骨外缘至前交通动脉最近点距离为48.52-58.86mm,前交通动脉复合体最大可显露路径假想线与额极交点距鼻根点的距离为31.48-54.26mm,均值分别为22.45°、53.35 mm、40.23 mm,前交通动脉复合体数据与参考文献无明显差异,未见明显解剖变异情况。结论：经前纵裂入路手术特别是需涉及需要暴露前交通动脉复合体的手术如前交通动脉及胼周动脉动脉瘤夹闭术、三脑室前部颅咽管瘤、鞍上发展明显顶部较高的垂体瘤及其他肿瘤的摘除术需注意骨瓣大小、手术目的暴露的合适角度、手术入路深度及前交通动脉、回返动脉、前交通动脉复合体穿支动脉的正常及变异情况等,本实验研究可为其提供部分数据参考依据。
[Abstract]:Objective: to simulate the bilateral frontal coronal incision through the single frontal anterior longitudinal fissure approach, and to observe and measure the anatomical factors involved in the approach, the anterior communicating artery complex and its adjacent structures. The factors needing attention in the exposure of anterior communicating artery complex through anterior longitudinal fissure approach were discussed. Methods: to provide anatomic basis for anterior longitudinal fissure operation, especially for the operation involving anterior communicating artery complex. 1.0% 15 wet specimens of Chinese adults with necked cadavers were stained with red and blue latex. After bleaching, the double frontal coronal incision was simulated through the single frontal anterior longitudinal fissure approach, and the maximum exposure path of the anterior communicating artery complex and the angle between the long axis of the skull base and the anterior communicating artery complex were measured. Vernier caliper was used to measure the distance from the outer margin of the skull at the nasal root point to the nearest point of the anterior communicating artery, the distance between the imaginary line of the anterior communicating artery and the intersection point of the frontal pole and the nasal root point, and the number of branches of the anterior communicating artery. And the number of internal perforating arteries and return arteries, and observe the vessels and nerves in the interspace under the microscope, and the various forms of the vessels. Record and photograph walking and variation. Results:. During the exposure of the anterior communicating artery complex through the anterior longitudinal fissure approach, the angle between the maximum exposure path of the anterior communicating artery complex and the long axis of the skull base was 15.36-28.54 掳. The distance from the outer margin of skull to the nearest point of anterior communicating artery was 48.52-58.86mm. The distance between the maximum exposure path of the anterior communicating artery complex and the intersection of the frontal pole and the nasal root was 31.48-54.26mm, and the mean value was 22.45 掳/ 53.35 mm, respectively. 40.23 mm. There was no significant difference between the data of anterior communicating artery complex and references. Conclusion: the anterior longitudinal fissure approach is necessary to expose the anterior communicating artery complex, such as anterior communicating artery and pericallosal artery aneurysm. For craniopharyngioma of the anterior part of the third ventricle, the size of bone flap, the appropriate angle of exposure, the depth of operation approach and the anterior communicating artery should be paid attention to in the excision of pituitary tumor and other tumors with obvious apical top of suprasellar development. The normal and variation of recurrent artery, anterior communicating artery complex perforating artery, etc., this study can provide some reference data for it.
【学位授予单位】：桂林医学院
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R322;R651.1

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