大脑中央回区浅静脉的显微解剖学研究  

Microanatomical study of superficial veins in the brain central gyrus region

作　　者：贤俊民[1] 丰育功[2] 

机构地区：[1]菏泽市立医院神经外科,山东省274031 [2]青岛大学医学院附属医院神经外科

出　　处：《中华神经外科杂志》2016年第10期1025-1028,共4页Chinese Journal of Neurosurgery

摘　　要：目的 观察大脑中央回区浅静脉的显微解剖结构.方法 利用20具（40侧）尸头标本,动、静脉分别用红、蓝色乳胶灌注,在显微镜下利用中央前回的“手结”定位中央沟,观察中央沟附近的静脉构成并测量相关的数据.结果 40侧标本中,中央回区静脉主要由中央前静脉构成者10侧（25.0％）,主要由中央沟静脉构成者13侧（32.5％）,主要由中央沟静脉及中央前或后静脉构成者6侧（15.0％）,由粗大的Trolard静脉构成者11侧（27.5％）.40侧标本中,29侧（72.5％）存在29支中央前静脉,管径为0.69 ～ 6.96 mm;32侧（80.0％）存在35支中央沟静脉,管径为1.38 ～5.66 mm;39侧（97.5％）存在41支Trolard静脉,管径为0.44～2.60 mm;5侧（12.5％）存在5支中央后静脉,管径为0.74～2.30 mm;40侧（100％）存在43支旁中央静脉,其潜行于硬膜下腔距离为0.4～0.9 cm,平均（0.6±0.3）cm,回流角度为40.7 ～81.7°. 结论 大脑中央区浅静脉的构成形式变异性大,回流静脉支多,回流路径迂曲,与毗邻的静脉属支易于混淆;旁中央静脉回流入上矢状窦或其旁的静脉腔隙、中央回区静脉的角度大,在硬膜下腔潜行的距离短,限制了纵裂的牵开宽度;虽然Trolard静脉出现率高,且有时明显粗大,但仍要严格保护中央区静脉.Objective To observe the microsurgical anatomy of superficial veins in the brain central gyrus region.Methods Twenty （40 sides） cadaver head specimens were used,and the arteries and veins were perfused with red or blue latex.Under the microscope,the hand-knob of precentral gyrus was used to locate the central sulcus.The related data of venous constitution near the central sulcus were observed.Results In the 40-side specimens,the veins of central gyrus region was mainly composed of precentral veins in 10 sides （25%）,was mainly composed of central sulcus veins in 13 sides （32.5%）,was mainly composed of central sulcus veins and precentral or postcentral veins in 6 sides （15%）,and was composed of thick Trolard＇s veins in 11 sides （27.5%）.Of the 40-side specimens,29 sides （72.5%） had 29 precentral veins,the diameters were 0.69 cm to 6.96 cm;32 sides （80.0%） had 35 central sulcus veins,the diameters were 1.38 cm to 5.66 cm;39 sides （97.5%） had 41 Trolard＇s veins,the diameters were 0.44 cm to 2.60 cm;5 sides （12.5%） had 5 postcentral veins,the diameters were 0.74 cm to 2.30 cm.Forty sides （100%） had 43 paracentral veins,they sneaked in the subdural spaces,the ranges were 0.4 cm to 0.9 cm （mean,0.6 cm ± 0.3 cm）,the return angles were 40.7 ° to 81.7°.Conclusions The variability of the constitution forms of the superficial veins in the cerebral central region is great,the reflux veinous branches are more,the return paths are tortuous,and it is easy to be confused with the adjacent branches of the veins.The angle of the paracentral veins flowing into the superior sagittal sinus or the venous spaces nearby,and the veins in the central gyrus region is large.The sneak distance is short in the subdural space and limits the retractor width of the longitudinal fissure.Although the appearance rate of the Trolard vein is high and sometimes is significantly thick,the veins in the central region still need to be strictly protected.

关 键 词：脑静脉 神经解剖学 显微外科手术 

分 类 号：R322.8[医药卫生—人体解剖和组织胚胎学]