本文關鍵詞： 上胸椎 前方手術入路 解剖 臨床意義　出處：《吉林大學》2006年碩士論文　論文類型：學位論文

【摘要】：上胸椎(C7-T4)系頸胸交界與胸椎延續(xù)的一個重要結構匯合區(qū)域。其前方手術入路常因所涉及鄰近解剖結構復雜,手術難度較大、術野顯露困難,手術高危險性等而受到限制。而國內外針對該入路的相關解剖學研究資料尚欠缺,需要經上胸椎前方進行手術減壓患者有逐漸增多趨勢,為進一步闡明該部位的解剖結構,探索該入路的優(yōu)越性,為上胸椎前方手術入路提供更為安全解剖顯露方式,為此我們開展了相關的解剖學研究工作。本研究通過21具固定、1具新鮮成人尸體標本模擬經典[10]和改良上胸椎前路手術術式[11],對上胸椎前方手術入路的血管、神經和胸導管等進行了系統(tǒng)觀察,觀測所涉及的重要血管、神經、胸導管的走行及與上胸段脊柱的解剖關系,重點研究分析了喉返神經、胸導管及血管與椎體的對應關系以及縱隔間隙在前方手術入路中的作用,從解剖學方面對兩種前方手術入路進行了總結。結論:認為改良上胸椎前方手術入路適用于C4-T4椎體病變的手術。該入路具有顯露充分,創(chuàng)傷小,手術操作安全方便等優(yōu)點,可滿足頸胸段椎管前方減壓、植骨融合及內固定術。此入路從解剖學角度觀察,是安全可行的,為臨床手術入路提供解剖學依據。
[Abstract]:C7-T4) is an important confluence region between the cervical and thoracic junctions and thoracic vertebrae. The anterior approach is often difficult to expose due to the complexity of the adjacent anatomical structure involved, the difficulty of surgical operation, and the difficulty of exposing the surgical field. In order to further clarify the anatomical structure of this site, there is a tendency to increase the number of patients who need surgical decompression through the front of the thoracic vertebrae to further clarify the anatomical structure of the site, due to the lack of relevant anatomical research data at home and abroad, such as the high risk of the operation. To explore the advantages of this approach and to provide a more safe anatomical exposure method for the anterior approach of upper thoracic vertebrae. In this study, 21 fresh adult cadavers were used to simulate classical [10] and modified anterior thoracic vertebrae operation [11] to evaluate the vessels of anterior thoracic vertebra approach. The nerves and thoracic ducts were observed systematically, the important vessels, nerves and thoracic ducts involved and the anatomical relationship with the upper thoracic spine were observed, and the recurrent laryngeal nerve was studied and analyzed. The relationship between thoracic catheters and blood vessels and vertebral body, and the role of mediastinal space in anterior surgical approach, Two kinds of anterior surgical approaches were summarized from anatomical aspects. Conclusion: the modified anterior thoracic vertebra approach is suitable for the operation of C4-T4 vertebral lesions. This approach has the advantages of sufficient exposure, less trauma, safe and convenient operation, and so on. It can be used for anterior decompression of cervical and thoracic spinal canal, bone graft fusion and internal fixation. This approach is safe and feasible from anatomic point of view and provides anatomic basis for clinical approach.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2006
【分類號】：R322

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