前床突磨除后颈内动脉床突段解剖及临床意义  

Anatomy and Clinical Significance of Exposed Clinoid Segment of Internal Carotid Artery after Removing Anterior Clinoid Process

作　　者：曹刚[1] 涂汉军[2] 张力[1] 黄宽明[1] 

机构地区：[1]湖北医药学院附属太和医院神经外科 [2]湖北医药学院,湖北十堰442000

出　　处：《湖北医药学院学报》2014年第4期339-342,F0003,共5页Journal of Hubei University of Medicine

摘　　要：目的:对前床突(anterior clinoid process,ACP)、磨除前床突后颈内动脉(internal carotid artery,ICA)床突段进行解剖观察和测量,为临床显微神经外科手术治疗该区域的血管、肿瘤、神经等疾病提供解剖学依据。方法:利用15例(30侧)10%福尔马林固定的成人尸头湿标本,对前床突、颈内动脉床突段进行显微解剖,观察和测量前床突、颈内动脉床突段及其周围裂隙和相互之间的关系。结果:前床突长(9.62±0.23)mm、宽(12.19±0.32)mm、厚(5.31±0.18)mm;床突尖动脉距前床突尖前为(3.70±0.80)mm,出现率为16.7%(5侧),1侧在尖部,3侧在正下方,1侧在内侧,直径为(0.70±0.20)mm;前床突气化率为10%。颈内动脉床突段起于近侧硬膜环,止于远侧硬膜环,床突段长(5.14±0.74)mm。结论:磨除前床突是治疗颈内动脉眼动脉段动脉瘤和颈内动脉床突段动脉瘤的特殊技术和难点所在,磨除前床突时如果前床突气化,注意填塞气房,防止脑脊液漏。Objective To dissect and measure the anterior clinoid process（ ACP） and the exposed clinoid segement of internal carotid artery（ ICA） after removing ACP which will provide anatomic basis for microneurosurgery treatment of the vascular,tumorous,neural disease in this region. Methods Fifteen adult cadaveric head specimens（ 30 sides） were fixed by 10%formalin,the ACP and clinoid segement of ICA were micro-dissected and their length,width and thickness were measured.The relationship of ACP,clinoid segement of ICA and the peripheral rupture was analyzed. Results The length,width and thickness of ACP was（ 9. 62 ± 0. 23） mm,（ 12. 19 ± 0. 32） mm,（ 5. 31 ± 0. 18） mm,respectively. The distance from ACP artery to ACP apex was（ 3. 7 ± 0. 8） mm,and its frequency was 16. 7%（ 5 sides） with one side located at the apex,three sides at the bottom,one side at the inner side,the mean diameter was（ 0. 70 ± 0. 20） mm. The gasification rate of ACP was10%. The clinoid segement of ICA was started at proximal dural ring,and terminated at distal dural ring with a length of5. 14（ ± 0. 74） mm. Conclusion The grind of ACP is critical for the treatment of carotid aneurysms at the segment of ophthalmic artery and ICA. The gasification was formed in the ACP when removing it,blocking its gasification could prevent leakage of cerebrospinal fluid.

关 键 词：前床突 颈内动脉 显微外科解剖 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]