CAJ | 학술논문

背景:有关视交叉池的显微观测指标不完善. 目的:探讨视交叉池的境界、池内各结构测值、特征及临床意义. 设计:抽样调查. 地点及对象:在咸宁学院医学院手术显微镜室观测制备好的视交叉池,男 16例,女 4例,估计年龄 30～ 60岁. 干预:在手术显微镜下剔除额叶,保留其额叶下面的软脑膜、蛛网膜及鞍区周围的结构,观察、测量视交叉池的境界及池内各结构的相互关系及相关值. 主要观察指标:视交叉池境界、池内各结构的相互关系、特征及相关值. 结果:视交叉池是由视神经之间、视交叉和鞍膈上面相互延伸的蛛网膜所围成.在池内,视神经颅内段左右侧长度为( 9.89± 2.63) mm ,厚度为( 2.96± 0.82) mm .视交叉前后径为( 10.87± 1.63) mm ,左右径为( 13.38± 1.52) mm,厚度为( 4.68± 0.72) mm;视交叉正常型 10例,占 50% ;前置型 7例,占 35%;后置型 3例,占 15%.垂体柄长度为( 5.98 ± 2.7) mm, 前后径为( 1.59± 0.42) mm ,左右径为( 1.96± 0.44) mm.纤维网直径小于 0.06 mm. 结论:视交叉池内结构以视交叉中心,前续视神经,后邻垂体柄,下隔鞍膈邻脑垂体等;池内各结构借纤维网和缠结在纤维网上的小血管彼此牵连;故使池内结构显得非常复杂.在鞍区手术中应重点保护好视神经和视交叉及池内血管等.
배경:유관시교차지적현미관측지표불완선. 목적:탐토시교차지적경계、지내각결구측치、특정급림상의의. 설계:추양조사. 지점급대상:재함저학원의학원수술현미경실관측제비호적시교차지,남 16례,녀 4례,고계년령 30～ 60세. 간예:재수술현미경하척제액협,보류기액협하면적연뇌막、주망막급안구주위적결구,관찰、측량시교차지적경계급지내각결구적상호관계급상관치. 주요관찰지표:시교차지경계、지내각결구적상호관계、특정급상관치. 결과:시교차지시유시신경지간、시교차화안격상면상호연신적주망막소위성.재지내,시신경로내단좌우측장도위( 9.89± 2.63) mm ,후도위( 2.96± 0.82) mm .시교차전후경위( 10.87± 1.63) mm ,좌우경위( 13.38± 1.52) mm,후도위( 4.68± 0.72) mm;시교차정상형 10례,점 50% ;전치형 7례,점 35%;후치형 3례,점 15%.수체병장도위( 5.98 ± 2.7) mm, 전후경위( 1.59± 0.42) mm ,좌우경위( 1.96± 0.44) mm.섬유망직경소우 0.06 mm. 결론:시교차지내결구이시교차중심,전속시신경,후린수체병,하격안격린뇌수체등;지내각결구차섬유망화전결재섬유망상적소혈관피차견련;고사지내결구현득비상복잡.재안구수술중응중점보호호시신경화시교차급지내혈관등.
BACKGROUND:The accurate data about the microstructure of chiasmatic cistern are still not available. OBJECTIVE:To explore the boundary,microstructure,characteristics and clinical significance of chiasmatic cistern. DESIGN:Sample survey. SETTING and PARTICIPANTS:The study was carried out at the Operation Microsscope Room of Medical College of Xinning College.Chiasmatic cistern sample was collected from 16 males and 4 females with their ages ranged from 30 to 60 years old. INTERVENTIONS:Frontal lobe was eliminated with operation microscope,while the soft meninges under frontal lobe,arachnoid and sphenoid saddle surrounding configuration were kept for investigating the boundary of chiasmatic cistern and the anatomical relationship of its microstructures. MAIN OUTCOME MEASURES:The boundary of chiasmatic cistern,morphometry and anatomical relationship of its microstructures,characteristics and its relative value. RESULTS:Chiasmatic cistern was surrounded by arachnoid extended from between optical nerves to optic chiasm and sphenoid saddle.In the chiasmatic cistern,bilateral length of encephalic segment of optic nerve was( 9.89± 2.63) mm with thickness of( 2.96± 0.82) mm.The longitudinal diameter of optic chiasm was( 10.87± 1.63) mm with transversal diameter of( 13.38± 1.52) mm and thickness of( 4.68± 0.72) mm.Optic chiasm was found normal in 10 patients(50% ),prepositive in 7 patients(35% ),and postpositive in 3 patients(15% ).Length of pituitary handle was( 5.98± 2.7) mm with longitudinal diameter of 1.59± 0.42) mm and transversal diameter of( 1.96± 0.44) mm.The aperture of fibrin net was smaller than 0.06 mm. CONCLUSION:Optic chiasm is the center of chiasmatic cistern,which is surrounded by anterior optical nerves, posterior pituitary handle,and inferior pituitary with sphenoid saddle between them.The microstructures of chiasmatic cistern is connected with each other by fibrin net and vessels tangled on it, making chiasmatic cistern a complex structure.Therefore,anatomical study of optical nerves,optical chiasm,and vessels in chiasmatic cistern should be carefully protected during clinical operations at sphenoid saddle.