乙状窦后入路静脉及相关结构显微解剖与临床应用

发布时间：2018-03-08 07:14

本文选题：乙状窦后入路　切入点：静脉　出处：《青岛大学》2012年硕士论文　论文类型：学位论文

【摘要】：[目的]通过对枕下乙状窦后入路相关静脉的构成及毗邻结构进行研究,分析其解剖学特征及与周围神经、血管的关系,探讨后颅窝静脉系统及其变异对手术治疗颅内病变可能产生的影响。 [方法]利用15具尸头标本,动、静脉分别以红蓝色乳胶灌注,在显微镜下模拟枕下乙状窦后入路,观察术中相关静脉及其属支的分布、走行及与周围组织的关系,对岩静脉等重要血管进行详细解剖并测量相关的数据；总结并掌握静脉对病变定位和手术指导的作用。 [结果]乙状窦后入路相关的静脉可分为三部分：(1)初始部：包括横窦,乙状窦,小脑半球枕面浅静脉；(2)中间部：脑桥、延髓前方及前外侧静脉及三脑裂中的静脉等；(3)基底部：包括岩静脉、岩上下窦等。横窦-乙状窦结合部(乙状窦膝)对开颅时关键孔的定位具有指示作用。脑干外侧静脉可能会受到桥小脑角区病变的影响引起继发性改变。岩静脉应该是引起是三叉神经痛的病因之一。 [结论](1)后颅窝静脉系统构成变异较大,吻合众多,小脑浅静脉尤为多见；(2)部分静脉与临床疾病关系密切,以岩静脉为代表；(2)部分静脉在手术过程中具有定位和指导意义,以横窦乙状窦结合部为代表；(4)尽管静脉血管吻合支众多,但某些重要结构间的静脉仍应尽量保留,以减少术后并发症；(5)桥脑小脑角区结构复杂,遍布重要结构,应完善术前影像学检查并强化解剖及显微手术训练。
[Abstract]:[objective] to analyze the anatomical characteristics and the relationship with peripheral nerves and blood vessels by studying the composition and adjacent structure of the vein associated with the retrosigmoid approach of the suboccipital sinus. To investigate the influence of posterior cranial fossa venous system and its variation on the surgical treatment of intracranial lesions. [methods] Fifteen cadaveric head specimens, arteries and veins were perfused with red and blue latex to simulate the retrosigmoid sinus approach under the microscope. The distribution of the related veins and their branches during the operation were observed, and the relationship between them and the surrounding tissues was observed. The important vessels such as petrosal vein were dissected in detail and relevant data were measured, and the role of vein in localization and operation guidance was summarized and grasped. [results] the vein associated with retrosigmoid approach can be divided into three parts: the initial part: transverse sinus, sigmoid sinus, superficial occipital vein of the cerebellar hemisphere. The anterior and anterolateral veins of the medulla oblongata, and the veins in the cleft of the triencephalon. The transverse sinus-sigmoid sinus joint (sigmoid sinus knee) can indicate the location of the critical foramen during craniotomy. The lateral cerebral stem vein may be affected by the lesion of the cerebellopontine angle area and cause secondary changes. It should be one of the causes of trigeminal neuralgia. [conclusion] the posterior cranial fossa venous system is of great variation and anastomosis, especially the superficial cerebellar vein. Part of the veins is closely related to clinical diseases. Although there are many anastomosed branches of venous vessels, the veins between some important structures should be preserved as far as possible to reduce postoperative complications. 5) the structure of cerebellopontine angle area is complex, and the important structure is widespread. The preoperative imaging examination should be improved and the training of anatomy and microsurgery should be strengthened.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R322

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