摘要
目的:研究颈内动脉分叉上间隙的结构及其在鞍区大型肿瘤手术中的应用价值。方法:在8侧尸体头上采用翼点入路观察颈内动脉分叉上间隙的显微结构;并对磁共振诊断为大型垂体瘤7例及颅咽管瘤4例者,采取翼点入路、联合应用颈内动脉分叉上间隙及颅底第1￣4间隙,行瘤内减压、逐步切除肿瘤。结果:颈内动脉分叉上间隙由大脑前动脉的A1段、大脑中动脉的M1段及前穿质围成,是一个狭小的组织间隙,内有Heubner等穿支动脉通过;颈内动脉分叉上间隙被瘤体扩大并可见肿瘤壁,经此间隙可分离、切除肿瘤上部,最终肿瘤全切5例、次全切3例、大部切除3例。视力改善10例、失明1例。一过性尿崩5例、需要长期药物控制2例。结论:颈内动脉分叉上间隙的应用可增加肿瘤上部的显露,有助于手术切除和减少相关并发症。
Objective： To study the anatomical characteristics of interspaces superior to the fork of internal carotid artery and the applica-tion in surgery. Methods： The microanatomy of these interspaces was studied in 8 sides of human cadaver specimen with sphenoid approach. Seven cases of pituitaries and four craniopharyngiomas were diagnosed by MRI, which were removed bit by bit through the interspace superior to the fork of internal carotid artery and the first to the fourth interspaces in skull base. Results： The superior interspaces were abounded by A1 segment of anterior cerebral artery,M1 segment of middle cerebral artery and anterior perforated substance, which was a narrow interspace, containing Heubner artery and the other arteries. In our study the superior interapaces of internal partior tumors could be seen through superior interspaces of internal artery, and superior parts of tumors could be dissected tbrough the interspaces. At last five tumors were completely removed, three subremoved and another three partially removed. Conclusion： The application of the interspace superior to the fork of internal carotid artery will be beneficial to expose superior part of tumors in sellar aera, which will decrease the rate of syndrome related to the operating processes.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2006年第6期410-412,F0002,共4页
Journal of Nanjing Medical University(Natural Sciences)
关键词
鞍区肿瘤
颈内动脉上间隙
显微解剖
外科手术
tumor in sellar aera
interspace superior fork of internal carotid artery
microanatomies
surgical operation
