颌内动脉-大脑中动脉搭桥的解剖学研究  

Anatomical research of maxillary artery to middle cerebral artery bypass

作　　者：高树梓[1] 石祥恩[1] 柳成荫[1] 韩光魁[1] 

机构地区：[1]首都医科大学附属复兴医院神经外科,北京100038

出　　处：《中华神经外科杂志》2013年第11期1131-1134,共4页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金（81271520）;首都卫生发展科研专项基金（2011-7011-02）

摘　　要：目的探讨颌内动脉（MA）第二段与大脑中动脉第二段（M2）之间移植搭桥的可行性。方法取5具成人尸头行双侧解剖，分离颞浅动脉（STA）主干及其分支，测量STA主干近分叉部的血管外径；游离MA第二段，断其远端并测量MA第二段长度和血管外径，以此断端作为吻合口近端；行额颞开颅，打开侧裂池，分离出M2段起始端并测量其血管外径，以M2起始端作为吻合口远端；观察和测量MA第二段与M2起始端之间的行程和距离。结果MA第二段断端的血管外径（2．42±0．20）mm，大于STA主干近分叉处的血管外径（1．70±0．24）mm；颞下窝内MA第二段长度（断端到MA近下颌颈前缘处）为（17．94±1．31）mm；M2下干起始端血管外径为（2．13±0．11）mm；跨过骨窗缘测得MA第二段断端到M2起始端距离是（57．92±1．24）mm，二者之间距离较短且移植路径较直。结论行MA第二段与M2起始端之间搭桥在解剖上是可行的，具有移植血管取材短、移植路径直的优点。Objective To investigate the feasibility of bypass between the second segment of internal maxillary artery （MA） and the second segment of middle cerebral artery （MCA）. Methods Five fixed and perfused adult cadavers were dissected bilaterally. After a frontotemperal craniotomy, the superficial temporal artery （STA）and its branches were dissected and their diameters at the bifurcation of STA were measured. The second segment of the MA, which was under the zygomatie arch, was dissected in the infratemporal fossa. The length and diameter of the second segment of MA were measured respectively. Its distal artery was cut off and its proximal artery was used as proximal anastomotic end. After a frontotemporal craniotomy was carried out and the sylvian fissure was opened. The proximal M2 was separated and its outer diameter was measured. The proximal M2 was used as distal anastomotic end. The length between MA and the proximal M2 was measured and the graft routing was observed. Results The mean caliber of MA （2. 42 ± 0. 20） mm was larger than the mean caliber of the STA tnmk（ 1.70 ±0. 24） mm. The mean length of the second segment of MA in the infratemporal fossa was （ 17. 94 ± 1.31） mm. The mean caliber of the proximal M2 was （2.13 ±0.11） mm. The length between MA and the proximal M2 was （57. 92 ± 1.24） mm, which was shorter and the graft routing was straighter. Conclusions The second segment of MA to M2 bypass might be a promising option for those patients who need receive bypass operations. The graft was shorter and the routing was straighter.

关 键 词：搭桥术 颌内动脉 大脑中动脉 颞下窝 

分 类 号：R743[医药卫生—神经病学与精神病学]