经神经内窥镜侧脑室手术入路的应用解剖  

Applied anatomy on operative approach of lateral ventricle in endoscopic surgery

作　　者：张亚莉[1] 陈英杰[1] 贾建鑫[2] 陈绍春[1] 

机构地区：[1]昆明医学院解剖学教研室,昆明650031 [2]漯河市中心医院麻醉科,漯河462000

出　　处：《解剖学杂志》2009年第1期107-109,共3页Chinese Journal of Anatomy

基　　金：云南省教育厅立项项目(5Y0514C)

摘　　要：目的:为神经内窥镜下侧脑室手术相对安全的穿刺路径提供解剖学依据。方法:模拟神经内窥镜手术,分别从侧脑室的额角、颞角、三角区和枕角4种入路对固定后的成人颅脑标本进行解剖观测,分析比较不同手术入路的优劣。结果:E2点与脑膜中动脉和大脑上静脉毗邻;N1～N3点与脑膜中动脉毗邻;N4点的体表定位点位于颞上回,深部正对颞横回;Z1～Z3点穿经视辐射,Z3点距角回最近,Z5、Z6与大脑上吻合静脉毗邻。结论:(1)额角入路相对于来说比较安全,只是定位准确,在穿刺过程中不会伤及血管和重要的神经中枢;(2)经颞角入路进行穿刺时,有损伤脑膜中动脉的危险;(3)三角区入路不常用,并且易损伤听辐射;(4)枕角入路利于手术中多部位的探查。Objective： To provide anatomical basis for neuroendoscopes surgery in the lateral ventricle of a safe operative approach. Methods： The structures of lateral ventricle of adult formalin-fixed cadaveric head specimens were observed and measured by simulating endoscopic surgery. Analyze and compare the advantages and disadvantages of the four operative approaches： the anterior horn approach, the inferior horn approach, the triangular area approach and the occipital horn approach. Results： E2 was adjacent to the middle meningeal artery and the superior cerebral vein; N1 - N3 were also adjacent to the middle meningeal artery; The anchor point on the body surface of N4 was on the superior temporal gyrus where the gyri temporales transversi just was in the deep part; The optic radiation was punctured by Z1 - Z3, Z3 was the nearest to the angular gyrus, and Z5 and Z6 were adjacent to the superior anastomotic vein of the brain. Conclusion： （1） The anterior horn approach is relatively safe with little lesion to the blood vessel and the nerve center on condition that the location on the body surface is accurate; （2） It is possible to impair the middle meningeal artery from the inferior horn approach; （3） The triangular area approach was seldom used for its risk to impair the acoustic radiation; （4） It is expedient of cornu oceipitale approach to explore several regions in the operation.

关 键 词：侧脑室 神经内窥镜 手术入路 应用解剖 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学] R651[医药卫生—基础医学]