鼻部血管的应用解剖及临床意义

发布时间：2018-01-03 08:18

本文关键词：鼻部血管的应用解剖及临床意义　出处：《山东大学》2009年硕士论文　论文类型：学位论文

【摘要】： 研究背景鼻部是面部的重要器官,是面部美容的重要结构。鼻部的手术不单单是去除病变组织,恢复功能,更需要注重鼻部外形的修复和美观。临床上对鼻部缺损的修复做了很多研究,提出了许多方式和方法。近年来显微外科的迅速发展为鼻部缺损的修复和重建创造了良好条件。已有多例断鼻再植成功的报道。但临床上对鼻部血管走行的研究还不十分透彻,这导致了一些鼻部手术的失败。本文就近年来面动脉主要血管区域的应用解剖学研究作一综述,并着重研究鼻部皮肤血管的来源、走行及与周围血管的交通情况,为鼻部缺损的修复及断鼻再植的血管供应提供解剖学基础。目的解剖鼻部血管并观察鼻部血管的走行规律和变异情况方法采用颈动脉乳胶灌注的方法对10例标本进行灌注并解剖,观察鼻部的血管走行情况并测量实验数据。总结鼻部血管的走行规律。结果鼻部皮肤的血管走行特点 (1)鼻软骨部的血管多走行于软骨内。鼻部皮肤的血供主要来自两侧面动脉发出上唇动脉后继续向上延续而成鼻外侧动脉。鼻外侧动脉约在鼻翼角水平发出鼻底支供应鼻底皮肤和鼻粘膜。而后其主干继续向上约在鼻骨与鼻软骨交界处发出鼻翼支供应鼻部皮肤并与来自对侧的分支相交通,该分支沿途发出许多细小的分支分别供应鼻软骨部的皮肤和鼻粘膜,是鼻软骨部皮肤血供的主要来源。 (2)鼻翼动脉多是鼻外侧动脉在鼻骨与鼻软骨交界处和鼻翼角之间发出鼻翼支,极少数标本由眼动脉的终末支鼻背动脉发出,该动脉在鼻翼向对侧走行并与对侧鼻翼动脉吻合形成一条动脉弓。在多数标本上该弓由优势侧鼻外侧动脉发出横跨鼻翼至对侧鼻外侧动脉的分支形成。该弓沿途发出许多细小的分支分别供应鼻软骨部的皮肤和鼻粘膜,并与鼻小柱动脉交通,是鼻软骨部皮肤血供的主要来源。 (3)双侧鼻翼动脉通过鼻中柱动脉与双侧上唇动脉的鼻底部交通支相连构成两个围绕鼻两侧鼻翼的环状结构。当一侧面动脉受损时,可以经此结构由对侧代偿供血。 (4)鼻部血管的变异情况在解剖过程中发现鼻部血管走行存在较大变异。10具尸体共20侧面动脉有5侧(均为左侧)鼻外侧动脉缺如,缺如侧的血供由对侧和眼动脉穿出内眦向下的终末支提供。两侧鼻外侧动脉的的管径也有较大差异,其中右侧优势者占多数(70%)。结论鼻部的血供大多数来自鼻外侧动脉或内眦动脉。鼻翼皮肤存在连接两侧鼻外侧动脉的动脉弓。双侧鼻翼的动脉通过鼻中柱动脉与双侧上唇动脉的鼻底部交通支相连构成两个围绕鼻两侧鼻翼的环状结构。当一侧面动脉受损时,可以经此结构由对侧代偿供血。
[Abstract]:Background nose is an important organ of the face and an important structure of facial beauty. Nasal surgery is not only to remove pathological tissue and restore function. More need to pay attention to the shape of the nose and beauty. Clinical repair of nasal defects have done a lot of research. In recent years, the rapid development of microsurgery has created good conditions for the repair and reconstruction of nasal defects. Many successful cases of nasal replantation have been reported. Not very thorough. This has led to the failure of some nasal surgery. This article reviews the applied anatomy of the main vascular regions of the facial artery in recent years, and focuses on the origin of the nasal skin vessels. The walking and communicating with the surrounding vessels provide anatomic basis for the repair of nasal defects and the supply of blood vessels for the replantation of broken nose. Objective to dissect nasal vessels and observe the regularity and variation of nasal vessels Method Ten specimens were perfused and dissected by the method of carotid latex perfusion. The blood vessels of the nasal region were observed and the experimental data were measured. Results The characteristics of nasal skin vascularity 1). The blood supply of nasal skin mainly comes from the upper labial artery of the two sides and then continues upward to form the lateral nasal artery. The lateral nasal artery sends out the nasal fundus about at the level of the alar angle. The trunk continues to supply the nasal skin at the junction between the nasal bone and the nasal cartilage and communicates with the branches from the contralateral side. Many small branches along the way supply the skin of nasal cartilage and nasal mucosa respectively, which is the main source of skin blood supply in nasal cartilage. (2) most of the alar artery is the lateral nasal artery which sends out the alar branch between the nasal bone and the nasal cartilage and the angle of the alar, and a few specimens are from the nasal dorsal artery, which is the final branch of the ophthalmic artery. The artery travels contralateral through the nasal wing and anastomoses with the contralateral alar artery to form an arterial arch. In most specimens, the arch is formed by a branch of the dominant lateral nasal artery across the nasal wing to the contralateral nasal artery. The arch is along the way. It emits many small branches that supply the skin and nasal mucosa of the nasal cartilage, respectively. The arterial communication with nasal column is the main source of skin blood supply in nasal cartilage. 3) the bilateral alar artery is connected to the nasal bottom communicating branch of bilateral upper lip artery through the middle column artery of the nose to form two annular structures surrounding both sides of the nose, when one side artery is damaged. The blood supply may be compensated by the contralateral structure. In the course of dissection, there was a great variation in the route of nasal vessels. There were 10 cadavers with 20 lateral arteries and 5 (all left) lateral nasal arteries were absent. The blood supply of the absent side was provided by the contralateral and ophthalmic arteries passing through the terminal branches down the medial canthus. The diameter of bilateral lateral nasal arteries was also different. Conclusion most of the nasal blood supply comes from the lateral nasal artery or the medial canthus artery. The alar skin has an arterial arch connecting the bilateral lateral nasal artery. The bilateral alar artery passes through the middle nasal column artery and the bilateral upper lip artery to the bottom of the nose. The connecting branches form two annular structures surrounding the nasal wings. When a lateral artery is damaged. The blood supply may be compensated by the contralateral structure.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R322

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