经额底纵裂入路前交通动脉复合体的显微解剖研究  

Microanatomy of anterior communicating artery complex via fronto-basal interhemispheric approach

作　　者：高树梓 安德柱 仪新锋 李佳岩 廖长春 GAO Shu-zi;AN De-zhu;YI Xin-feng;LI Jia-yan;LIAO Chang-chun(Department of Neurosurgery,Zhuhai People′s Hospital,Zhuhai Guangdong 519000,China)

机构地区：[1]珠海市人民医院神经外科,广东珠海519000

出　　处：《局解手术学杂志》2020年第5期354-357,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：珠海市2018年度市卫计局医学科研基金(20181117A010017)。

摘　　要：目的探讨显微解剖下经额底纵裂入路及相应的前交通动脉复合体相关指标,分析前交通动脉复合体结构分布情况。方法选择完整浸泡于10%福尔马林的成人尸头标本15具(30侧),在显微镜下经额底纵裂入路进行解剖,检测和分析大脑前动脉远侧部位和前交通动脉复合体的显微解剖相关指标,观察重要动脉血管分布情况。结果大脑前动脉A1段的左侧管径(2.67±0.29)mm,长度(133.68±1.63)mm;右侧管径(2.24±0.35)mm,长度(13.21±1.31)mm;出现变异的标本有2例(13.3%)。A2段的左侧管径(2.48±0.43)mm,长度(19.24±3.27)mm;右侧管径(2.51±0.52)mm,长度(20.15±3.54)mm;均未见变异和不对称情况。前交通动脉的长度为0~8.9 mm,平均(3.51±0.88)mm;直径为0~4.0 mm,平均(1.24±0.61)mm。前交通动脉的穿通支有1~5支,平均(2.3±1.01)支。Heubner回返动脉未见发育异常,其长度为21.14~37.52 mm,平均(27.11±3.15)mm。结论经额底纵裂入路对人体头颅进行解剖,分析前交通动脉复合体相关指标,明确了该部位的解剖结构及分布情况,有助于指导该部位前交通动脉复合体的结构分析、病变探索和临床手术。Objective To study the distribution of the anterior communicating artery complex by the fronto-basal interhemispheric approach and the corresponding index of the anterior communicating artery complex under microanatomy.Methods A total of 15 adult cadaveric head specimens(30 sides)immersed in 10%formalin were selected to dissect by fronto-basal interhemispheric approach under microsurgical microscope,and the microscopic anatomical indicators of the distal anterior cerebral artery and the anterior communicating artery complex were detected and analyzed,and the distribution of important arteries was observed.Results The left side diameter of the A1 segment of the anterior cerebral artery was(2.67±0.29)mm,the length was(133.68±1.63)mm,the right side diameter was(2.24±0.35)mm,and the length was(13.21±1.31)mm.There were 2 cases with a variation in the A1 segment,the ratio was 13.3%.While the left side diameter of the A2 segment was(2.48±0.43)mm,and the length was(19.24±3.27)mm,the right side diameter was(2.51±0.52)mm,the length was(20.15±3.54)mm,and the A2 segment showed no variation nor dissymmetry.The length of the anterior communicating artery was 0 to 8.9 mm,with an average of(3.51±0.88)mm,the diameter was 0 to 4.0 mm,with an average of(1.24±0.61)mm.There were 1 to 5 perforating branches of the anterior communicating artery,with an average of(2.3±1.01).No abnormal development was observed in Heubner′s recurrent artery,the length of Heubner′s recurrent artery was 21.14 to 37.52 mm,with an average of(27.11±3.15)mm.Conclusion The human skull is dissected by fronto-basal interhemispheric approach to analyze the corresponding index of the anterior communicating artery complex and to confirm its anatomical structure and distribution,which is helpful to guide the structural analysis,pathologic exploration and clinical operation of the anterior communicating artery complex.

关 键 词：额底纵裂入路 大脑前动脉 前交通动脉复合体 显微解剖 前交通动脉瘤夹闭术 显微外科手术 

分 类 号：R322.121[医药卫生—人体解剖和组织胚胎学]