远外侧手术入路的显微解剖和临床研究

发布时间：2018-05-27 17:27

本文选题：远外侧入路 + 枕骨大孔　；参考：《河北医科大学》2006年硕士论文

【摘要】： 目的:通过对成人尸体头颅干性、湿性标本的解剖和测量,为远外侧手术入路提供详细的解剖学数据,以利于临床工作中改进手术方式,在术中保护重要组织结构,增加手术的安全性,扩大手术的适应征范围,减少手术并发症。方法:对8例成人头颅干性标本,20例寰枢椎干性标本进行解剖学测量。对8例(16侧)经福尔马林溶液固定的不同性别成人头颅湿性标本进行血管灌注染色后模拟远外侧手术入路进行解剖并测量。干性头颅及寰枢椎标本均为经过沸煮、深埋等方法处理,可直接使用。利用游标卡尺等工具分别测量枕骨大孔相关径线,包括枕骨大孔纵径、枕骨大孔横径、乳突尖至枕髁外侧缘距离、枕髁纵径、枕髁后缘至舌下神经内口的距离等。寰枢椎的相关数据包括寰椎后结节高度、宽度、后弓半距、横突孔前后径、左右径、侧块左右径、侧块内、外侧高度、枢椎齿突高度等。经福尔马林溶液固定的尸头标本,自椎动脉和颈内动脉灌注尿激酶溶液,结扎灌注血管,冲洗后配制血管染色灌注液,自椎动脉和颈内动脉加压灌注血管染色灌注液,结扎灌注血管。放置48小时后使动脉血管充分染色并尽量还原原有组织形态。利用头颅湿性标本,分别在左侧和右侧双侧进行模拟手术。将尸头置于简易头架上,将头向对侧旋转30o,皮肤沿皮下筋膜层剥开,辨认胸锁乳突肌和副神经。在胸锁乳突肌
[Abstract]:Objective: to provide detailed anatomical data of cadaveric dry and wet cadaveric cadavers in order to improve the operation mode and protect important tissue structure during operation. Increase the safety of surgery, expand the scope of surgical adaptation, and reduce complications. Methods: 20 atlantoaxial dry specimens of 8 adult cadaveric cadavers were anatomically measured. Vascular perfusion staining was performed on 8 adult cadaveric wet specimens fixed with formalin solution, and anatomic results were measured through a simulated far lateral approach. Dry head and atlantoaxial specimens are treated by boiling, deep embedding and can be used directly. The relative diameter of foramen magnum was measured by Vernier caliper, including longitudinal diameter of foramen magnum, transverse diameter of foramen magnum of occipital bone, distance between mastoid tip and lateral margin of occipital condyle, longitudinal diameter of occipital condyle and distance between posterior edge of occipital condyle and internal orifice of hypoglossal nerve. The atlantoaxial data include the height, width, posterior arch distance, anteroposterior diameter of transverse foramen, left and right diameter, medial and lateral height of lateral mass, height of odontoid process of axis, etc. The cadaveric head was fixed with formalin solution. Urokinase solution was perfused from vertebral artery and internal carotid artery, then ligated and perfused with blood vessel. After washing, blood vessel staining perfusion fluid was prepared, and blood vessel staining perfusion fluid was perfused from vertebral artery and internal carotid artery under pressure. Ligation and perfusion of blood vessels. After 48 hours, the arterial vessels were stained and the original tissue morphology was reduced as much as possible. The simulated operation was performed on both left and right sides of head wet specimen. The cadaveric head was placed on a simple head frame. The head was rotated to the opposite side for 30 o.The skin was peeled off along the subcutaneous fascia to identify the sternocleidomastoid muscle and accessory nerve. In the sternocleidomastoid muscle
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R651;R322

【共引文献】