颈内动脉解剖与海绵窦瘘临床治疗研究  

The anatomy of internal carotid artery and the treatment for the cavernous sinus fistula

作　　者：程龙海[1] 罗杰[1] 付锐[1] 张力[1] 鲁军体[1] 曹刚[1] 张相华[1] 武高 

机构地区：[1]湖北医药学院附属太和医院神经外科一病区,湖北十堰442000

出　　处：《中华神经外科疾病研究杂志》2013年第6期484-488,共5页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的对颈内动脉解剖的分布特点进行观察和测量分析,为海绵窦瘘显微手术治疗提供解剖学指导。方法用12例福尔马林浸泡固定的尸头标本在显微镜下(共24侧)观察,红色乳胶灌注的双侧颈内动脉及椎动脉尸头标本,对海绵窦段分支与及其相邻近组织结构进行解剖、观察及和测量。收集50例海绵窦瘘患者,采用Seldinger技术并介入拴塞治疗。结果海绵窦段在水平面上可观察到呈S形向前和向后形弯曲,脑膜垂体干、海绵窦下动脉及McConnell背囊动脉是海面窦段主要的3个分支。最常见的2个分支是脑膜垂体干和海绵窦下动脉。50例颈内海绵窦瘘患者均为外伤后,经介入栓塞治疗后痊愈出院,随访1年半未见复发。结论颈内动脉解剖复杂,颈内海绵窦瘘多见于外伤。经颈内动脉入路治疗颅内动脉瘤及海绵窦瘘,是近年来一种比较热门,发展较快,疗效较好的显微尖端技术。它和常规手术相比明显优势在于手术创伤小,效果明显,疗效可靠,恢复快等优点。Objective To investigate the anatomy of the internal carotid artery and to provide the anatomical data for the mierosurgieal treatment of cavernous fistula. Methods A total of 12 eases of formalin fixed eadaverie head specimens （a total of 24 sides under the microscope） whose bilateral internal carotid artery and vertebral artery were already marked by the red latex perfusion for the observation and measurement of all segments of the intraeranial arteries branches and the structure of the adjacent tissues. Seldinger technology and intervention embohzation were performed in all 50 patients. Results Cavernous segment in the horizontal plane presented a S-shape bend. Meninges pituitary stem, cavernous sinus artery and MeConnell backpack artery were the three main branches. A total of 50 patients with carotid cavernous fistula eaused by traunm were eured by intervention embolization, and no recurrence occurred during the follow-up of 1.5 years. Conclusion The internal artery is complex in anatomy and the trauma is the primary cause for the carotid cavernous fistula. The treatment of intracranial aneurysras and cavernous fistula via internal carotid artery approach is a new and effective mierosurgieal technique with less injury, mere effectiveness and good recovery.

关 键 词：颈内动脉 海绵窦瘘 介入治疗 解剖学研究 

分 类 号：R651.12[医药卫生—外科学]