颅颈交界区显微外科解剖研究  

Microsurgical anatomy of the cranio-cervical junction region

作　　者：付爱军[1] 朱军[1] 李建珉[1] 程爱国[1] 

机构地区：[1]华北煤炭医学院附属医院神经外科,唐山063000

出　　处：《安徽医科大学学报》2005年第3期234-237,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的探讨颅颈交界区各结构毗邻关系,为临床安全处理颅颈交界区病损提供显微解剖学依据。方法15例(30侧)国人成年带颈头颅湿性标本在手术显微镜下进行解剖观察和测量。结果枕下段椎动脉测量左右两侧直径有显著差异,以左侧大于右侧为主。上、下枕下三角是保护椎动脉第三段的重要标志。头外侧直肌是确认颈静脉孔后外侧缘的标志、二腹肌后腹是保护面神经的标志。枕髁后1/3～1/2的磨除可获得对枕骨大孔腹侧和腹外侧的满意显露。颈静脉结节的磨除对于增加枕骨大孔上方病变的显露非常重要。结论颅颈交界区结构毗邻关系复杂,掌握该区的显微解剖特点和解剖学标志,可增加该区手术的安全性。枕髁和颈静脉结节的磨除可增加手术视野。Objective To study the microsurgical anatomy of the cranio-cervical junction region and provide basic anatomical landmarks and parameters for dealin g with pathological changes of the cranio-cervical junction region safely. Methods Microsurgical anatomy and measurement were performed in both si des of 15 adult cadaver’s heads. Results The superior suboccopital triangle and inferior suboccipital triangle were important landmarks for distin guishing vertebral artery. The rectus capitis lateralis muscle was an excellent landmark for identifying the posterior margin of the jugular foramen. The poster ior belly of the diagastric muscle provide a useful landmark for identifying the facial nerve. Drilling the posterior 1/3~1/2 of occipital condyle and jugular t ugular improved the surgical exposure. Conclusion The structure of cranio-cervical junction region is complex; grasping the microsurgical (anatomy) of the cranio-cervical junction region can increase the safety of related opera tions. The resection of occipital condylar and jugular tuber canincrease surgical freedom.

关 键 词：颅颈交界区 椎动脉 枕髁 显微外科解剖 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学]