CAJ | 학술논문

目的研究经小脑延髓裂(CMF)入路相关的显微解剖结构和毗邻关系,在不切开下蚓部情况下,分离CMF获得最充分的术野.方法应用显微外科解剖技术,对经甲醛固定、血管乳胶灌注的5具成人湿性尸头标本,按不同手术入路逐层解剖,观察相关组织和血管的形态结构和毗邻关系,并做了测量和统计分析.结果 CMF入路不需切开下蚓部,可完全纵向显露从闩部至导水管下口,侧向显露从闩部至外侧孔的第四脑室底及脑桥背外侧区域.比较小脑下蚓部入路,CMF入路纵向显露距离差异无统计学意义(P＞0.05),侧向显露距离明显大于下蚓部入路(P＜0.05).结论 CMF入路可充分显露CMF、第四脑室周围、脑桥区域,比较下蚓部入路,显露充分,神经组织损伤小,手术安全性提高.
목적 연구경소뇌연수렬(CMF)입로상관적현미해부결구화비린관계,재불절개하인부정황하,분리CMF획득최충분적술야.방법 응용현미외과해부기술,대경갑철고정、혈관유효관주적5구성인습성시두표본,안불동수술입로축층해부,관찰상관조직화혈관적형태결구화비린관계,병주료측량화통계분석.결과 CMF입로불수절개하인부,가완전종향현로종산부지도수관하구,측향현로종산부지외측공적제사뇌실저급뇌교배외측구역.비교소뇌하인부입로,CMF입로종향현로거리차이무통계학의의(P＞0.05),측향현로거리명현대우하인부입로(P＜0.05).결론 CMF입로가충분현로CMF、제사뇌실주위、뇌교구역,비교하인부입로,현로충분,신경조직손상소,수술안전성제고.
Objective To study the microanatomy of related structures of transcerebellomedullary fissure approach (trans -CMF approach), and to refine the trans -CMF approach to obtain an appropriate operative view without splitting the inferior vermis. Methods The microsurgical anatomy structures of trans - CMF approach were studied by using 5 formalin - fixed, silicone - perfused cadaveric heads specimens.Results Trans -CMF approach provided a sufficient operative access to fourth ventricle from the lower opening of aqueduct and foramina of Luschka to the obex. There was no difference in portrait distance ( P＞ 0.05) between the approach splitting the inferior vermis and trans - CMF approach, but there was statistically significant difference in lateral distance ( P ＜ 0. 05 ). Conclusion Trans - CMF approach chould provid a sufficient operative view from the fourth ventricle to dorsolateral part of pons and medulla through normal anatomic spaces and reduce the injury of nervous tissue , thus obtain an appropriate operative view and security.