颅脑基底静脉前段的显微解剖观察_医学论文.docVIP

颅脑基底静脉前段的显微解剖观察_医学论文 颅脑基底静脉前段的显微解剖观察_医学论文 作者：陈兵 丰育功 张丽云 唐万忠 李环廷 【摘要】 目的 了解基底静脉前段的显微解剖结构，以便在翼点手术入路中更好地保护。方法 取15具（30侧）尸头标本，动、静脉分别用红、蓝色乳胶灌注，在显微镜下模拟翼点手术入路，分别从手术中常用的间隙进行操作，观察基底静脉前段与手术间隙的关系。最后去除颅盖骨，在游离的脑标本上对基底静脉本干及其属支进行观察、测量，统计相关数据。结果 有4侧基底静脉前段缺如，22侧紧贴视束后行，4侧距离视束较远。基底静脉前段的长度为（7.83±1.73）mm，直径（1.73±0.78）mm；前段紧贴视束处与视交叉外侧缘的距离为（12.11±0.24）mm。大脑前静脉与大脑中深静脉汇合处距视交叉外侧缘（14.36±1.67）mm，距颈内动脉分叉处（8.13±0.98）mm，距大脑中动脉的最近距离为（7.65±0.21）mm。结论 经翼点入路对鞍区肿瘤进行手术时，熟悉基底静脉的显微解剖，可以在手术中减少其损伤，减少术中出血和术后并发症的发生。 【关键词】 脑静脉；显微外科手术；解剖学,局部 　　［ABSTRACT］ Objective To study the microanatomy of the anterior segment of basal vein to ensure its preferable protection during pterion operative approach. Methods Fifteen cadaveric heads were taken in this study. The arteries and veins of the heads were perfused with red and blue latex, respectively, for simulating pterion approach under microscope. The spatial relationship between the anterior segment of basal vein and the operation space was examined. The cranium was then removed, the basal vein and its branches were observed and measured in the free brain. Results Four basal veins lacked of anterior segment, 22 ran closely behind the fasciculus opticus, and four were distant from the fasciculus opticus. The average length of the anterior segments of basal veins was (7.83±1.73) mm, the diameter was (1.73±0.78) mm. The distance between the anterior segment adhering to fasciculus opticus and lateral border of chiasm opticum was (12.11±0.24) mm. The distances between the confluence of anterior cerebral vein with deep middle cerebral vein and the lateral border of chiasm opticum, the crotch of ICA and MCA were (14.36±1.67) mm, (8.13±0.98) mm and (7.65±0.21) mm, respectively. Conclusion Having an intimate knowledge of microanatomy of basal vein is conducive to the decrease of damage, intraoperative bleeding, and postoperative complications for surgery of sellar tumors. ［KEY WORDS］ cerebral vein microsurgery anatomy, regional 翼点入路是颅底显微神经外科最常用的手术入路之一,广泛应用于处理鞍区、前颅底、中颅底甚