经前额纵裂入路的神经内镜与显微解剖学及临床应用  

Endoscopic Anatomy and Microanatomy of the Interhemispheric Approach

作　　者：袁磊[1] 赵冬[1] 刘祺[1] 冯洪涛[1] 郭伟[1] 范高阳[1] 王业忠[1] 

机构地区：[1]新疆石河子大学医学院第一附属医院神经外科,石河子832008

出　　处：《中国微创外科杂志》2010年第2期166-168,共3页Chinese Journal of Minimally Invasive Surgery

基　　金：新疆建设兵团医药卫生专项基金(编号:2008GG33)

摘　　要：目的通过对经前额纵裂入路的内镜解剖与显微解剖学研究,为临床提供解剖学参考。方法8例成人尸头,取经前额纵裂入路,在显微镜和内镜下对其内部结构进行全程观察。采用经前额纵裂入路手术22例。结果通过显微镜及不同角度内镜,能够观察到鞍区和第三脑室结构。22例中,动脉瘤5例均成功夹闭,肿瘤全切13例,近全切除3例,大部切除1例,无死亡病例,无严重并发症的发生。结论内镜辅助显微镜经前额纵裂入路对鞍区及第三脑室前部暴露良好,对周围组织损伤小,是切除鞍区和第三脑室前部肿瘤的较佳入路。Objective To explore the endoscopic anatomy and microanatomy of transfrontal-interhemispheric approach so that to provide anatomic basis for clinical surgery.Methods Eight adult cadaveric heads were observed following the interhemispheric approach under a microscope and endoscope.Meanwhile,22 patients treated via the interhemispheric approach were studied.Results Through different anatomical fissures,with the help of endoscope and microscope we could observe the structure of the sellar and third ventricle without making any injuries to the normal tissues.Of the 22 cases,the aneurysms of anterior circulation was clipped in 5,total removal of the tumors was achieved in 13,subtotal removal in 3,and mostly removed in 1.None of the patients developed severe peri-operative complication.Conclusions The merits of the surgery through endoscope-assisted interhemispheric approach include good exposure of the structures in the sellar region and third ventricle anterior,and less injury to the surrounding tissues.It is a good approach for resection of tumors in the anterior part of the third ventricle and the sellar region.

关 键 词：内镜 显微镜 解剖 纵裂入路 

分 类 号：R651[医药卫生—外科学] R322[医药卫生—临床医学]