枕下极外侧入路应用解剖学探讨及手术体会  

Applied anatomy of far lateral suboccipital approach and its clinical experience

作　　者：姬云翔[1] 王业忠[1] 赵冬[1] 朱立仓[1] 代林志[1] 田卫东[1] 

机构地区：[1]石河子大学医学院第一附属医院神经外科,新疆石河子832000

出　　处：《解剖学报》2016年第3期365-367,共3页Acta Anatomica Sinica

基　　金：石河子大学重大科技攻关计划项目(gxjs2010-zdgg01-04)

摘　　要：目的探讨枕下极外侧入路切除延颈交界区腹侧病变的效果,并对一些手术技巧加以讨论。方法在10例成人尸头上模拟枕下极外侧入路进行延颈交界区腹侧局部显微解剖探讨,观测延颈交界区有关结构。采用枕下极外侧入路对26例延颈交界区腹侧及腹外侧病变进行手术治疗。结果本组26例患者,9例痊愈,17例好转。14例肿瘤全切除,12例次全切除。全组无手术死亡。术后并发症包括面瘫2例,后组脑神经轻度麻痹1例,脑脊液漏1例。结论枕下极外侧入路可以满足延颈交界区腹侧及腹外侧病变手术野的显露,是切除该部位病变的一种有效的手术方法。Objective To analyse the operative results of removing craniocervical junction region（ CCJR）,and its surgical techniques. Methods Micro-anatomy of craniocervical junction region was studied in 10 adult cadaver heads for simulation of far lateral suboccipital approach. The structure of the extension neck junction was observed. The far lateral suboccipital opproach was used on 26 cases with lesions surgery of the anterior or anterolateral CCJR. Results Of 26 patients,9 patients were recovered and 17 patients improved. There were 14 cases of tumor resection,and 12 cases of subtotal resection. There was no operative mortality. Postopertive complications included facial paralysis in 2 cases,mild cranial nerve palsy in 1 case,and cerebrospinal fluid leakage in 1 case. Conclusion The far lateral suboccipital approach can extensively reveal the surgical field of the anterior and anterolaeral CCJR,and is an effective surgical resection of the lesion site.

关 键 词：颅底外科 延颈交界区 枕下极外侧入路 显微解剖 人 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]