经侧裂脑岛叶入路治疗基底节脑出血的显微解剖修改稿分析.doc

经侧裂岛叶入路治疗基底节脑出血的显微解剖 马东 黄建军 马喜 伊志强 韩光迅 白永文 张素勤 摘要：目的 研究经大脑外侧裂岛叶入路治疗基底节脑出血显微解剖并为手术操作提供显微解剖数据。方法 对13例（26侧）成人尸头进行外侧裂、大脑中动脉及岛叶、基底节区的显微解剖与测量。结果 ①外侧裂各分支的平均长度：前横支26.30mm±6.20mm，前升支 36.00mm±10.10mm，后支43.00mm±7.10mm。②大脑中动脉各段平均长度及直径：M1段22.90mm±6.50mm，2.00±0.40mm；M2段26.80mm±10.80mm，1.60±0.40 mm；M3段19.00mm±7.40mm，1.30±0.30 mm。③岛叶额盖宽平均2.83mm±0.94mm，顶盖宽平均2.86mm±0.74mm，颞盖宽平均3.83mm±1.07mm；短回平均长度1.88mm±0.35mm，长回平均长度3.26mm±0.52mm，岛叶中央沟平均长度2.89mm±0.51mm。结论 大脑中动脉（MCA）分布于侧裂深部及岛叶表面，呈M状排列；经岛叶中前1/3的短回间脑沟和血管间隙是进入基底节区清除血肿的最佳路径。 关键词： 外侧裂；大脑中动脉；脑岛叶；基底节区；脑出血；显微解剖 Microsurgical anatomy of the transsylvian-insula approach for intracerebral hemorrhage in basal ganglia MA Dong*, HUANG Jian-jun, YI Zhi-qiang, HAN Guang-xun, BAI Yong-wen, MA Xi, ZHANG Su-qin. * Neurosurgery Department of General Hospital of Datong Coal Mine Group Company,Datong 037003,China Corresponding author: HUANG Jian-jun,Email: hjj1958@126.com Abstract: Objective To study the Microsurgical anatomy of the transsylvian- insula approach for intracerebral hemorrhage in basal ganglia and to provide related anatomical data for operative procedures. Methods 13 cadaver heads（26 sides） were used. The sylvian fissure, middle cerebral artery, insula and basal ganglia were dissected and measured. Results ①The average length sylvian fissure: anterior transverse branch was 26.30±6.20mm, anterior ascending branch 36.00±10.10 mm and posterior branch 43.00±7.10mm.②The average length and diameter of Middle Cerebral Artery(MCA) branches: M1 22.90±6.50mm,2.00±0.40mm; M2 26.80±10.80 mm,1.60±0.40mm; M3 19.00±7.40mm, 1.30±0.30mm.③The average width of frontal operculum of the insula was 2.83±0.94mm,tectum was 2.86±0.74mm,temporal operculum was 3.83±1.07mm; the average length of short gyrus was 1.88±0.35mm, 作者单位：037003山西大同，同煤集团总医院神经外科（马东、黄建军、韩光迅、白永文、马喜、张素勤）；北京大学第一医院神经外科（伊志强） 通讯作者：黄建军，Email：hjj1958@126.com long gyrus was 3.26±0.52mm,central sulcus of the insula was 2.89±0.51mm. Conclu- Sions The branches of the MCA which form a M-lik