扩大经蝶入路到达颅底中央部肿瘤的显微解剖研究  

Transsphenoidal expanded to reach the tumor in central part of the skull base by microsurgical anatomy

作　　者：陈胜利[1] 乔志刚[2] 张汉伟[1] 张子屏[1] 胡涛[1] 王春红[1] 

机构地区：[1]山西省人民医院神经外科,太原030012 [2]山西省肿瘤医院神经外科

出　　处：《肿瘤研究与临床》2011年第5期314-317,共4页Cancer Research and Clinic

基　　金：基金项目：山西省卫生厅科技攻关项目（200620）

摘　　要：目的了解扩大经蝶人路到达颅底中央部肿瘤的显微解剖结构，为临床提供可靠的解剖学参数。方法对40例湿标本模拟扩大经蝶入路，在显微镜下对手术入路逐层解剖，对扩大暴露范围、重要结构及它们之间的毗邻关系进行观察、精确测量和拍摄。对40例干标本进行与手术人路相关骨质标本的精确测量和观察。结果扩大经蝶入路可以通过磨除骨质向前方、后方、外侧及鞍上扩展，可以显示额叶底面、视交叉前池、大脑前动脉复合体、颈内动脉海绵窦段及其分支、桥脑、基底动脉及分支、大脑后动脉及小脑上动脉等。结论扩大经蝶入路提供了处理累及颅底中央部肿瘤的新途径。Objective To study the microsurgical anatomy of the extended transsphenoidal approach to the central skull base, and provide anatomical parameters for the surgical approach. Methods Forty wet skulls were dissected in detail via mimic extended transsphenoidal approaches under an operating microscope and an extended exposed operating microscope. Important structures and connections were observed, measured precisely and photographed. Dry skulls were used to observe and measure the osseous structures related to the approaches. Results The extended transsphenoidal approach can expand ahead, astern and laterally to the suprasellar intradural space by resecting bone and displaying the basafrontal lobe, pre-chaismatic space, optic chiasma cistern, anterior cerebral artery complex, the branches and cavernous sinus segment of the internal carotid artery, pans, basilar artery and its branches, posterior cerebral artery, and superior cerebellar artery. Conclusion The extended transsphenoidal approach can provide the new pathway for treating lesions of the central skull base.

关 键 词：脑肿瘤 解剖学 局部 显微外科手术 

分 类 号：R739.4[医药卫生—肿瘤]