滑车神经行经小脑幕侧方区域的应用解剖学研究  

Applied Anatomy of the Trochlear Nerve in the Tentorial Lateral Region

作　　者：刘卫华[1] 周红利[2] 

机构地区：[1]成都医学院第一附属医院科研科,四川成都610500 [2]成都医学院人体解剖教研室,四川成都610500

出　　处：《华西医学》2009年第3期683-685,共3页West China Medical Journal

摘　　要：目的:通过对滑车神经行经小脑幕侧方区域的应用解剖学研究,寻找小脑幕侧方区域手术时避免损伤滑车神经的临床解剖标志。方法:对15例(男10例,女5例)防腐固定无畸形、无病变的成人头颅标本用红色乳胶灌注后,10倍手术显微镜下观察滑车神经在小脑幕侧方区域的行径,及其与周围重要神经、血管结构的毗邻关系,测量滑车神经长度、宽度、厚度及其与周围标志点的距离,并对所得结果进行统计学分析。结果:滑车神经在小脑上动脉和大脑后动脉之间向前行,进入小脑幕侧方区域,在动眼神经三角的后部穿越游离缘硬膜,其长度为(6.78±1.87)mm,宽度为(1.09±0.21)mm,厚度为(0.78±0.11)mm。滑车神经进入小脑幕侧方区域的入口处位于前床突、颈内动脉床突上段起始部、动眼神经入口后方,位于后床突后外方;距离前床突(23.24±3.18)mm、颈内动脉床突上段起始部(17.57±3.26)mm、动眼神经入口(11.42±3.32)mm;距离后床突(14.21±3.25)mm。结论:行小脑幕侧方区域手术时,为避免损伤滑车神经,前床突、后床突、颈内动脉床突上段起始部和动眼神经入口可以作为寻找滑车神经入口的重要标志,同时注意区分小脑上动脉和大脑后动脉。Objective： To study the trochlear nerve in the tentorial lateral region and to determine the important clinical anatomical landmarks of these important neurovascular structures to avoid injury of trochlear nerve. Methods： Fifteen cadaveric heads （ten male, five female） without deformity and disease of adults were examined using 10 times＇ magnification after perfusing the arteries with red latex and the relationship of the neural structures and arteries in the tentorial lateral region were observed. Trochlear nerve length, width, thickness and the distances between the important neursovascular structures and landmarks were measured, and the results were statistically analyzed. Results： The trochlear nerve entered forward into the tentorial lateral region between the superior cerehellar artery and posterior cer ebral artery , and through the free edge of subdural of oculomotor triangle. The length （ 6.78 ± 1. 87）mm , width （1.09±0.21）mm and thickness （0.78±0. 11）mm of trochlear nerve were measured. The entrance site of trochlear nerver located at （23.24±3.18）mm posterior to anterior clinoid process, （17.57±3.26）mm posterior to the supraelinoid portion of internal carotid artery, （11.42±3. 32）mm posterior to the entrance site of oculomotor nerve, （14.21±3.25）mm lateroposterior to the posterior clinoid process. Conclusion： During the operation of the tentorial lateral regional, to avoid injury trochlear nerve, the anterior clinoid process, the posterior clinoid process, the supraclinoid portion of internal carotid artery, the entrance site of oculomotor nerve can be used as important symbols to find out the trochlear nerve. Meanwhile, it is important to distinguish the superior cerebellar artery and posterior cerebral artery.

关 键 词：滑车神经 小脑幕侧方区域 应用解剖 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学]