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  本文選題：小腦幕切跡前間隙 + 腦池��； 參考：《吉林大學》2007年博士論文

【摘要】： 小腦幕切跡前間隙是神經外科解剖構成非常復雜的區(qū)域,同時也是顱內腫瘤的高發(fā)區(qū)域之一。由于小腦幕切跡前間隙的解剖復雜性以及病變的不同走向和生物學特性,決定了對此間隙精細顯微解剖的理解和掌握以及針對不同病變采取相應的手術入路是有效的完成手術、減少術后并發(fā)癥的關鍵。雖然當前對此間隙的顯微解剖及手術入路已有較為深入的研究,但仍有一些精細的解剖構成和手術入路的拓展方面尚需進一步探討研究以滿足臨床需要。 本實驗對10例尸頭標本通過逐步切除腦組織,對小腦幕切跡前間隙進行系統(tǒng)的的顯微解剖學觀察,為臨床提供相關的解剖學數(shù)據(jù);對6例尸頭標本分別模擬與小腦幕切跡前間隙相關較為常用的手術入路,為臨床在手術入路選擇的規(guī)范性和手術操作的安全性上提供參考。通過上述實驗,本文提出如下創(chuàng)新:①將起始于蝶棱和鐮狀皺襞連線處向后延伸構成視交叉池上層蛛網膜和嗅池后部蛛網膜的蛛網膜結構命名前顱底上層蛛網膜,后者有助于對切跡前間隙腦池空間構成的理解與掌握;②提出利用動眼神經門后緣作為鞍旁區(qū)與上巖斜區(qū)的大體解剖分界標志;③將垂體柄上部與視交叉之間的錐形空間命名為垂體柄上前間隙,后者可為切除鞍區(qū)病變時保護下丘腦-垂體柄和視力功能提供解剖支持;④在硬膜外將巖尖內側三角磨除,可進一步擴大顳下巖骨前入路的術野顯露,為小腦幕切跡前間隙后部病變的切除提供了更為廣闊的手術空間。
[Abstract]:The anterior space of tentorial incisor is a very complicated area in neurosurgical anatomy, and it is also one of the high incidence areas of intracranial tumors.Due to the anatomical complexity of the anterior tentorial notch space and the different trends and biological characteristics of the lesions, the understanding and mastering of the fine microanatomy of the space and the corresponding operative approach to the different lesions are effective in completing the operation.The key to reduce postoperative complications.Although the microanatomy and operative approach of this space have been studied deeply at present, there are still some fine anatomical components and the expansion of the operative approach which need to be further studied to meet the clinical needs.In this experiment, 10 cadaveric head specimens were subjected to systematic microanatomical observation of the anterior space of cerebellar tentorial incisors by gradual excision of brain tissue, which provided relevant anatomical data for clinical practice.Six cadaveric cadaveric specimens were used to simulate the common operative approaches associated with the anterior space of cerebellar tentorial incisors, which provided a reference for the selection of operative approaches and the safety of surgical procedures.Based on the above experiments, this paper proposes the following innovation: 1: 1 to form the arachnoid structure of the anterior skull base of the upper arachnoid layer of the optic chiasma cistern and the posterior part of the olfactory cistern by extending backward from the line between the sphenoid ridge and the sickle fold.The latter is helpful in understanding and mastering the spatial composition of the cisterns in the prenotch space. 2 the posterior margin of the oculomotor hilus is used as a gross anatomic boundary marker between the parasellar region and the superior petrosal oblique area.(3) the conical space between the upper part of the pituitary stalk and the optic chiasma was named as the anterior space of the pituitary stalk. The latter could provide anatomical support for the protection of hypothalamus-pituitary stalk and visual function in the excision of the lesions in the Sellar region.It can further expand the exposure of the surgical field through the anterior approach of the infratemporal petrosal bone and provide a wider surgical space for the resection of the posterior lesions of the anterior tentorial notch of the cerebellum.
【學位授予單位】：吉林大學
【學位級別】：博士
【學位授予年份】：2007
【分類號】：R651.1;R322

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本文編號：1748364