枕下极外侧入路的显微解剖研究  

Microanatomy of suboccipital extreme lateral approach

作　　者：付爱军[1] 朱军[1] 李建珉[1] 程爱国[1] 陈通[1] 刘清军[1] 刘刚[1] 张云鹤[1] 

机构地区：[1]河北联合大学附属医院神经外科,河北唐山063000

出　　处：《华北煤炭医学院学报》2011年第4期464-466,共3页Journal of North China Coal Medical College

基　　金：河北省科技厅科技计划项目(编号:032761135)

摘　　要：①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。②方法将15具（30侧）国人成年连颈尸体头颅湿性标本在手术显微镜下进行解剖观察和测量。③结果枕下段椎动脉测量左右两侧直径有显著性差异,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。④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 provides basic anatomical landmarks and parameters for dealing with pathological changes of the cranio-cervical junction region safely.Methods Microsurgical anatomy and measurement have been performed in both sides of 15 adult cadaver＇s heads.Results The superior suboccopital triangle and inferior suboccipital triangle were important landmarks for distinguishing vertebral artery.The rectus capitis lateralis muscle is an excellent landmark for identifying the posterior margin of the jugular foramen.The posterior belly of the diagastric muscle provides a useful landmark for identifying the facial nerve.Drilling the posterior 1/3-1/2 of occipital condyle and jugular tugular can improve the surgical exposure.Conclusion The structure of cranio-cervical junction region is complex;to grasp the microsurgical anatomy of the cranio-cervical junction region can increase the safety of related operations.The resection of occipital condylar and jugular tuber can increase surgical freedom.

关 键 词：颅颈交界区 椎动脉 枕髁 显微外科解剖 

分 类 号：R651.11[医药卫生—外科学]