腹腔镜腰交感神经节切除术的解剖学基础

发布时间：2018-10-05 09:51

【摘要】： 背景:血栓闭塞性脉管炎(Buerger’s病)主要发生于青壮年男性,累及四肢中小动静脉。该病被认为是一种自身免疫性疾病,目前尚无特效疗法,治疗上主要是防止病变进展,改善和增加患肢的血液循环,方法有药物治疗、动脉重建及腰交感神经切除术等。但单纯药物治疗难以达到理想治疗效果,而动脉重建又受患者自身条件限制。目前腰交感神经节切除术辅助以药物治疗是比较理想且经济的治疗方法。传统的腰交感神经节切除术由于切断肌肉较多、损伤较大等缺点限制了其在临床的应用。随着微创外科及电视腹腔镜等高新技术的发展,腹腔镜技术已应用于腹膜后手术操作。腹腔镜腰交感神经节切除术(video-assisted laparoscopic lumbar sympathectomy,VALLS)开始于上个世纪90年代。由于其集中了微创和传统手术的有效性等优点,在临床上更容易为患者及临床医生接受。但由于腰交感神经节的数目及位置变异较大,存在交感干分裂及交通支等,且手术是在非直视下进行,腰交感神经与毗邻结构的复杂关系加大了手术难度。因此对腰交感神经及周围毗邻结构的解剖关系进行系统描述以为临床开展该手术提供解剖学资料凸显重要。鉴于此,我们进行了本研究课题,并在此
[Abstract]:Background: thromboangitis obliterans (Buerger's 's disease) mainly occurs in young men, involving small and medium-sized arteries and veins of the extremities. The disease is considered to be an autoimmune disease, there is no special treatment, the main treatment is to prevent the progression of disease, improve and increase the blood circulation of the affected limb, such as drug treatment, artery reconstruction and lumbar sympathetic nerve resection, and so on. However, drug therapy alone is difficult to achieve ideal therapeutic effect, and arterial reconstruction is limited by the patient's own condition. At present, lumbar sympathetic ganglionectomy with drug therapy is an ideal and economical treatment method. The traditional lumbar sympathetic ganglionectomy has limited its clinical application because of more muscle cutting and more injury. With the development of minimally invasive surgery and TV laparoscopy, laparoscopic surgery has been applied to retroperitoneal surgery. Laparoscopic lumbar sympathetic ganglionectomy (video-assisted laparoscopic lumbar sympathectomy,VALLS) began in the 1990 s. Because it focuses on the advantages of minimally invasive and traditional surgery, it is more easily accepted by patients and clinicians. However, the number and location of lumbar sympathetic ganglion vary greatly, there are sympathetic trunk division and communicating branch, and the operation is carried out under the condition of non-direct vision. The complex relationship between lumbar sympathetic nerve and adjacent structure increases the difficulty of operation. Therefore, it is important to describe the anatomical relationship of lumbar sympathetic nerve and adjacent structures in order to provide anatomical data for clinical operation. In view of this, we have carried out this research project, and here we are
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322

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