小脑幕切迹前间隙的显微解剖及相关手术入路研究
本文选题:小脑幕切迹前间隙 + 脑池 ; 参考:《吉林大学》2007年博士论文
【摘要】: 小脑幕切迹前间隙是神经外科解剖构成非常复杂的区域,同时也是颅内肿瘤的高发区域之一。由于小脑幕切迹前间隙的解剖复杂性以及病变的不同走向和生物学特性,决定了对此间隙精细显微解剖的理解和掌握以及针对不同病变采取相应的手术入路是有效的完成手术、减少术后并发症的关键。虽然当前对此间隙的显微解剖及手术入路已有较为深入的研究,但仍有一些精细的解剖构成和手术入路的拓展方面尚需进一步探讨研究以满足临床需要。 本实验对10例尸头标本通过逐步切除脑组织,对小脑幕切迹前间隙进行系统的的显微解剖学观察,为临床提供相关的解剖学数据;对6例尸头标本分别模拟与小脑幕切迹前间隙相关较为常用的手术入路,为临床在手术入路选择的规范性和手术操作的安全性上提供参考。通过上述实验,本文提出如下创新:①将起始于蝶棱和镰状皱襞连线处向后延伸构成视交叉池上层蛛网膜和嗅池后部蛛网膜的蛛网膜结构命名前颅底上层蛛网膜,后者有助于对切迹前间隙脑池空间构成的理解与掌握;②提出利用动眼神经门后缘作为鞍旁区与上岩斜区的大体解剖分界标志;③将垂体柄上部与视交叉之间的锥形空间命名为垂体柄上前间隙,后者可为切除鞍区病变时保护下丘脑-垂体柄和视力功能提供解剖支持;④在硬膜外将岩尖内侧三角磨除,可进一步扩大颞下岩骨前入路的术野显露,为小脑幕切迹前间隙后部病变的切除提供了更为广阔的手术空间。
[Abstract]:The anterior space of tentorial incisor is a very complicated area in neurosurgical anatomy, and it is also one of the high incidence areas of intracranial tumors.Due to the anatomical complexity of the anterior tentorial notch space and the different trends and biological characteristics of the lesions, the understanding and mastering of the fine microanatomy of the space and the corresponding operative approach to the different lesions are effective in completing the operation.The key to reduce postoperative complications.Although the microanatomy and operative approach of this space have been studied deeply at present, there are still some fine anatomical components and the expansion of the operative approach which need to be further studied to meet the clinical needs.In this experiment, 10 cadaveric head specimens were subjected to systematic microanatomical observation of the anterior space of cerebellar tentorial incisors by gradual excision of brain tissue, which provided relevant anatomical data for clinical practice.Six cadaveric cadaveric specimens were used to simulate the common operative approaches associated with the anterior space of cerebellar tentorial incisors, which provided a reference for the selection of operative approaches and the safety of surgical procedures.Based on the above experiments, this paper proposes the following innovation: 1: 1 to form the arachnoid structure of the anterior skull base of the upper arachnoid layer of the optic chiasma cistern and the posterior part of the olfactory cistern by extending backward from the line between the sphenoid ridge and the sickle fold.The latter is helpful in understanding and mastering the spatial composition of the cisterns in the prenotch space. 2 the posterior margin of the oculomotor hilus is used as a gross anatomic boundary marker between the parasellar region and the superior petrosal oblique area.(3) the conical space between the upper part of the pituitary stalk and the optic chiasma was named as the anterior space of the pituitary stalk. The latter could provide anatomical support for the protection of hypothalamus-pituitary stalk and visual function in the excision of the lesions in the Sellar region.It can further expand the exposure of the surgical field through the anterior approach of the infratemporal petrosal bone and provide a wider surgical space for the resection of the posterior lesions of the anterior tentorial notch of the cerebellum.
【学位授予单位】:吉林大学
【学位级别】:博士
【学位授予年份】:2007
【分类号】:R651.1;R322
【参考文献】
相关期刊论文 前10条
1 吕衡发,高嵩,苏略;大脑中动脉的显微解剖及其临床意义[J];白求恩医科大学学报;1995年01期
2 张义泉,王卫红,冯春国,李长元;翼点入路显微手术切除前中颅底病变[J];中华神经医学杂志;2004年03期
3 吴喜跃,何理盛,康德智,陈陆馗;颅中窝底硬膜外入路技术改进及相关解剖学[J];福建医科大学学报;2003年01期
4 骆成,李监松,常莎,魏文洲;中颅窝孔道的CT研究及临床评价[J];海南医学院学报;1999年03期
5 王玉海!214044江苏无锡,蔡学见!214044江苏无锡,卢亦成!200003上海;Labbe静脉的显微解剖及其临床意义[J];国外医学.脑血管疾病分册;2001年04期
6 刘宏毅;邹元杰;张岩松;常义;张锐;吕著海;刘翔;;颈内动脉分叉上间隙的解剖及其在鞍区大型肿瘤手术中的应用[J];南京医科大学学报(自然科学版);2006年06期
7 伍洪昊,万丽丹,万卫,李美华;颞下经岩骨前部入路的临床应用解剖学研究[J];江西医药;2004年02期
8 铁欣昕,王欣,王运杰;经翼点入路鞍区手术间隙解剖学研究[J];解剖科学进展;2004年02期
9 朱国臣,娄卫华,孙永强,黄新辉,韩云志,袁林林;颈内动脉岩内段的显微解剖[J];解剖学杂志;2004年05期
10 黎国雄,赵洪洋,吴江,甄云,周育瑾;天幕裂孔区的应用解剖[J];解剖学杂志;2005年05期
,本文编号:1748364
本文链接:https://www.wllwen.com/yixuelunwen/binglixuelunwen/1748364.html