大脑前动脉A1段及前交通动脉复合体穿支动脉的显微解剖  

Microanatomy of A1 segment of anterior cerebral artery and perforating branch of communicating artery complex

作　　者：张广辉 王玉海[1] ZHANG Guang-hui;WANG Yu-hai(Wuxi Clinical Medical School,Anhui Medical University,Wuxi 214044,Jiangsu Province,China;Cranioeerebral Injury Cure Center of PLA,Department of Neurosurgery,lOlst Hospital of PLA,Wuxi 214044,Jiangsu Province,China)

机构地区：[1]安徽医科大学无锡临床学院,解放军第101医院神经外科全军颅脑损伤救治中心

出　　处：《中国临床解剖学杂志》2018年第5期481-485,共5页Chinese Journal of Clinical Anatomy

摘　　要：目的通过对前交通动脉复合体及其穿支动脉的显微解剖,为降低手术夹闭前交通动脉瘤的穿支动脉相关并发症提供解剖学依据。方法选取15具（30侧）尸头,充分暴露大脑前动脉A1段及前交通动脉复合体,显微镜下观察并测量各区域穿支动脉的数量、起始管径及分布区域等。将A1段按长度平均分为6区（A-F区）,观察6区穿支动脉的分布特点,寻找最佳临时阻断区。选取动脉内红色乳胶灌注充盈良好的10具尸头,显微镜下观测A1段髓质支及Heubner回返动脉自皮质至髓质的深度及分布区域。结果大脑前动脉A1段长度为（15.13±4.76）mm,其发出穿支动脉共244支,其中A区63支（25.82%）,B区54支（22.13%）,C区51支（20.90%）,D区31支（12.70%）,E区20支（8.20%）,F区25支（10.25%）。大脑前动脉A1段与A2段长度、穿支动脉数量及穿支动脉起始外径左右均无明显差异。结论熟悉前交通动脉复合体及其穿支动脉的解剖学特点是术中减少或避免穿支动脉损伤的关键。A1段E区常可作为最佳临时阻断区。Objective By microanatomy of the anterior communicating artery complex（ACoAC） and its perforation artery, the anatomic basis would be provided to reduce the perforator-related complications of the anterior communicating artery aneurysm（ACoAA）. Methods 15 cadaver heads（30 sides） were selected and fully exposed the A1 segment of the ACA and the ACoAC were performed. The number of perforating arteries, initial external diameter and distribution area were observed and measured under microscope. The A1 segment was divided into 6 regions（A-F area） according to the length. The characteristics of the perforating arteries in the 6 region were observed, to find the best temporary blocking area. 10 cadaver heads were filled with good perfusion of red latex in the arteries. The depth and distribution of the medullary branches of A1 segment and the Heubner returnee artery from the cerebral cortex to the cerebral pulp were observed and measured under the microscope. Results The length of the A1 segment of the ACA was（15.13±4.76）mm,from which the number of perforating artery was 244, including 63 in A area（25.82%）, 54 in B area（22.13%）,51 in C area（20.90%）, 31 in D area（12.70%）, 20 in E area（8.20%）, and 25 in F area（10.25%）. There was no significant difference in the length, the number of perforating arteries and the external diameter of perforating artery between A1 segment and A2 segment of ACA. Conclusion Familiarity with the anatomic characteristics of the ACoAC and its perforating artery is the key to reduce or avoid perforating artery injury during operation. The E region of A1 segment can be used as the best temporary blocking area.

关 键 词：前交通动脉复合体 前交通动脉瘤 大脑前动脉A1段 穿支动脉 显微解剖 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]