上胸椎前方手术入路解剖学观测与临床意义

发布时间：2018-02-28 06:04

本文关键词： 上胸椎前方手术入路解剖临床意义　出处：《吉林大学》2006年硕士论文　论文类型：学位论文

【摘要】：上胸椎(C7-T4)系颈胸交界与胸椎延续的一个重要结构汇合区域。其前方手术入路常因所涉及邻近解剖结构复杂,手术难度较大、术野显露困难,手术高危险性等而受到限制。而国内外针对该入路的相关解剖学研究资料尚欠缺,需要经上胸椎前方进行手术减压患者有逐渐增多趋势,为进一步阐明该部位的解剖结构,探索该入路的优越性,为上胸椎前方手术入路提供更为安全解剖显露方式,为此我们开展了相关的解剖学研究工作。本研究通过21具固定、1具新鲜成人尸体标本模拟经典[10]和改良上胸椎前路手术术式[11],对上胸椎前方手术入路的血管、神经和胸导管等进行了系统观察,观测所涉及的重要血管、神经、胸导管的走行及与上胸段脊柱的解剖关系,重点研究分析了喉返神经、胸导管及血管与椎体的对应关系以及纵隔间隙在前方手术入路中的作用,从解剖学方面对两种前方手术入路进行了总结。结论:认为改良上胸椎前方手术入路适用于C4-T4椎体病变的手术。该入路具有显露充分,创伤小,手术操作安全方便等优点,可满足颈胸段椎管前方减压、植骨融合及内固定术。此入路从解剖学角度观察,是安全可行的,为临床手术入路提供解剖学依据。
[Abstract]:C7-T4) is an important confluence region between the cervical and thoracic junctions and thoracic vertebrae. The anterior approach is often difficult to expose due to the complexity of the adjacent anatomical structure involved, the difficulty of surgical operation, and the difficulty of exposing the surgical field. In order to further clarify the anatomical structure of this site, there is a tendency to increase the number of patients who need surgical decompression through the front of the thoracic vertebrae to further clarify the anatomical structure of the site, due to the lack of relevant anatomical research data at home and abroad, such as the high risk of the operation. To explore the advantages of this approach and to provide a more safe anatomical exposure method for the anterior approach of upper thoracic vertebrae. In this study, 21 fresh adult cadavers were used to simulate classical [10] and modified anterior thoracic vertebrae operation [11] to evaluate the vessels of anterior thoracic vertebra approach. The nerves and thoracic ducts were observed systematically, the important vessels, nerves and thoracic ducts involved and the anatomical relationship with the upper thoracic spine were observed, and the recurrent laryngeal nerve was studied and analyzed. The relationship between thoracic catheters and blood vessels and vertebral body, and the role of mediastinal space in anterior surgical approach, Two kinds of anterior surgical approaches were summarized from anatomical aspects. Conclusion: the modified anterior thoracic vertebra approach is suitable for the operation of C4-T4 vertebral lesions. This approach has the advantages of sufficient exposure, less trauma, safe and convenient operation, and so on. It can be used for anterior decompression of cervical and thoracic spinal canal, bone graft fusion and internal fixation. This approach is safe and feasible from anatomic point of view and provides anatomic basis for clinical approach.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322

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