摘要
目的:为临床开展神经内窥镜下的第三脑室手术提供解剖学基础。方法:对18例尸头用断层解剖的方法进行解剖观测,测量确定手术入路各项目的数据。采用相同的方法在300例MRI上进行观测。经统计学处理,得出三脑室手术入路的参考数据。结果:①≤9岁年龄组第三脑室手术入路参数均值的95%可信区间分别是:乳头体前缘与室间孔连线的延长线与头皮的交点(B)、正中线与眦耳线线的交点(A)到正中线与经双侧外耳门的连线在颅顶的交点(C)的距离的比值(BC/AC)值为0.315￣0.334;入颅点旁开中线距离(L)为1.93￣2.65cm;入颅深度(H)为5.10￣6.51cm;内窥镜与正中矢状面的夹角(a)为21.8°￣23.0°。②10￣19岁、20￣29岁、30￣39岁、40￣49岁、50￣59岁、≥60岁各年龄组该入颅参数均值的95%可信区间是:BC/AC的比值分别为0.315￣0.340,0.320￣0.341,0.322￣0.340,0.322￣0.340,0.320￣0.337,0.325￣0.343;入颅点旁开中线距离(L)分别为2.30￣2.85,2.40￣3.10,2.40￣3.00,2.40￣3.23,2.40￣3.10,2.50￣3.10cm;入颅深度(H)分别为5.82￣7.30,5.70￣7.00,5.80￣6.80,6.00￣7.10,5.90￣6.95,5.70￣7.00cm;内窥镜与正中矢状面的夹角(θ)分别为19.5￣21.5°,19.0￣20.5°,20.0￣21.0°,19.5￣20.2°,18.9￣21.0°,19.0￣21.0°。结论:该入路具有操作简单,定位准确,适用范围广等优点。
Objective： To provide anatomic basis for endoscopic third ventricle surgery. Methods： With the method of sectional anatomy, 18 cadaveric head specimens were observed, measured and certified on the basis of operative approach, Similarly, MR/ images from 300 cases were observed and measured. After statistic processing, reference data of operating approach for third ventricle were obtained, Results： （1）The parameter intervals of the perforation of formal people who are under and equal to 9 years old in China was reliable to the degree of 95%, with the proportion of BC to AC 0.315--0.334; the middle line beside the incision 1.93- 2.65cm; the depth inside the skull 5.10-6.51 cm; and the angle between the endoscope and the center sagittal plane 21,8-23,0°. （2） The parameter intervals of the perforation of formal people whose age ranging from10-19, 20-29, 30-39, 40--49, 50-59, ≥60, with the proportion of BC to AC ranged from 0.315--0.340,0.320- 0.341,0.322--0.340,0.322-0.340,0.320-0.337 and 0.325-0.343 respectively;the middle line beside the incision 2.30-2.85 cm, 2.40-3.10cm, 2.40-3.00cm, 2.40-3.23cm, 2.40-3.10cm, 2.50-3.10cm; and the depth inside the skull 5.82-7.30cm, 5.70-7.00cm, 5.80-6.80cm, 6.00-7.10cm, 5.90-6.95cm, 5.70-7.00cm; the angle （0） between the endoscope and the center sagittal plane 19.5°-21.5°, 19.0°-20.5° ,20.0°-21.0°, 19.5°-20.2°, 18.9°-21.0°, 19.0° -21.0°, Conclusions： This localization approach enjoys the advantage of simplification, accuracy and wide application,
出处
《中国临床解剖学杂志》
CSCD
北大核心
2008年第4期373-375,共3页
Chinese Journal of Clinical Anatomy
关键词
第三脑室
手术入路
应用解剖
third ventricle
operating approach
applied anatomy
