内镜辅助显微镜在延颈交界区解剖中的研究  

Anatomical Research of Endoscopic Assisted Microscopy in the Extension of the Neck Junction

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作  者:惠鹏[1] 姬云翔[2] 董江涛[2] 王业忠[2] 赵冬[2] 

机构地区:[1]石河子大学医学院,石河子832002 [2]石河子大学医学院第一附属医院神经外科,石河子832008

出  处:《石河子大学学报(自然科学版)》2015年第2期179-182,共4页Journal of Shihezi University(Natural Science)

基  金:石河子大学重大科技攻关项目(GXJS2010-ZDGG-01)

摘  要:为对比研究内镜辅助显微镜与单纯显微镜对延颈交界区经枕下极外侧入路解剖的暴露范围及特点。探讨新的神经解剖学方法以及为临床手术提供解剖学资料。将10具(20侧)成人带颈头颅标本,采用内镜辅助显微镜按延颈交界区固有的解剖层次进行解剖、观察、测量并记录收据。同样的解剖方法,将10具(20侧)成人带颈头颅标本,在显微镜下按延颈交界区固有的解剖层次进行解剖、观察、测量并记录收据。对比两种解剖方法在解剖时间、最大暴露范围及测量所得的重要解剖标志点距离差异,并做统计学分析。结果显示,通过内镜辅助显微镜经枕下极外侧入路的解剖比单纯使用显微镜在解剖时间上明显缩短,使用神经内镜辅助显微镜组平均解剖时间为2.1±0.3 h,单纯使用显微镜组平均解剖时间为3.4±0.5 h(P<0.01);在暴露范围上,辅助神经内镜组较单纯显微镜组平均最大暴露视角增加12.76°±0.6°,视野平均增加7.32°±0.4 mm(P<0.01);二腹肌沟、枕骨髁、乳突尖、茎乳孔、颈静脉孔是枕下极外侧入路的解剖标志点;面听神经-舌咽神经间隙、舌咽神经-迷走副神经间隙为其重要手术操作间隙。是否应用内镜对重要解剖标志点的确认及距离的测量无统计学差异。由此可知,内镜辅助显微镜可更好的暴露该区的解剖结构、缩短解剖时间以及更精确的辨别重要解剖结构之间的关系,为临床医师快速、安全的切除该区病变提供解剖学依据。To study the dissecting scope and exposure characteristics of extension of the neck junction by endoscopic assisted microscopy and simple microscope, and to explore new neuroanatomieal methods and provide anatomical data for clinical surgery. 10 bodies (20 sides) of were dissected using endoscopic assisted microscope by extension of the neck junction inherent anatomy, and to observe, measure and record the receipt. The same anatomical methods, 10 bodies (20 sides) cadaveric head specimens were dissected only by microscope. Comparison of the two methods in dissection time, maximum exposure range and measured distance difference of important anatomical landmarks, and statistical analysis was conducted. Through the endoscope assisted microscope anatomy by suboccipital extreme lateral approach significantly shorter than simply used microscope on the dissection time. The average time of using neuroendoscope assisted microscopy group and microscope group was 2.1 ±0.3 h and 3.4 ±0.5 h (P〈0.01), respectively. The average maximum exposure perspective of neuroendoscope assisted group increased 12.76 ± 0.6 mm than the simple of microscope, the average vision increased 7.32 ±0.4 mm (P〈0.01). Digastric groove, condylus occipitalis, mastoidale stylomastoid foramen, jugular foramen were the anatomical landmark of extreme lateral suboccipital approach. The facial acoustic nerveglossopharyngeal nerve gap, glossopharyngeal nerve-vagus accessory nerve gap were the most two operation gaps. There was no statistical significance for important anatomic landmark identification and distance measurement. Accordingly, endoscope assisted microscope can better expose the anatomical structure, shorten dissection time and more accurate to identify the relationship between important anatomical structures. It can provide anatomical basis for clinicians fast and safe removal of the lesion area.

关 键 词:延颈交界区 解剖 入路 内镜 

分 类 号:R323.1[医药卫生—人体解剖和组织胚胎学]

 

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