颅内颈内动脉系统交感神经的显微解剖学研究

Microanatomy study of sympathetic nerve of intracranial internal carotid artery system

目的研究颅内颈内动脉系统交感神经的显微解剖。方法收集30例血管灌注的成人头颅标本,观察交感神经的走行及其与毗邻结构的关系,并测量相关解剖结构数据。结果通常交感神经在颈内动脉管内以2~3支神经束的形式走行,较粗的1支走在额侧,较细的1支走在枕侧,71.7%（43/60）标本的额侧神经束由1束组成,28.3%（17/60）由两小细束构成。96.7%（58/60）枕侧神经束主要由1束组成。2支神经束进入海绵窦内形成蝶鞍旁交感神经干,长度为（1.32±0.56）mm,然后分为展神经支和颈内动脉支,展神经支加入动眼神经、滑车神经、三叉神经和展神经,颈内动脉支向前形成两个神经丛：内侧丛和外侧丛,与颈内动脉伴行。结论交感神经走行、毗邻关系复杂,具有高度变异性。交感神经解剖学研究有助于减少颅内手术损伤。

Objective To study the microanatomy of the sympathetic nerves in the intracranial internal carotid artery system.Methods Thirty adult cadaveric heads fixed by vascular perfusion were selected.The course of sympathetic nerve of intracranial internal carotid artery system and its anatomic relationship with adjacent structures were observed,and the data of relative anatomical structures were measured.Results The sympathetic nerve usually ran in the form of two nerve bundles within internal carotid canal,including the thick bundle located in the frontal side while the thin one in the occipital side.Among the nerve bundles in the frontal side,71.7%（43/60） samples of the nerve bundle had only one bundle,and 28.3%（17/60） were composed of two thinner bundles.However,96.7%（58/60） samples of the nerve bundle in the occipital side had only one bundle.The occipital and frontal bundles entered the cavernous sinus and formed the parasellar sympathetic trunk,the length of which was 1.32±0.56 mm,then divided into the abducent nerve branch and internal carotid branch.The abducent nerve branch joined in oculomotor nerve,trochlear nerve,trigeminal nerve and abducent nerve.The internal carotid branch ran forward to form two nerve plexus,the medial and lateral plexus,which ran together with the internal carotid artery.Conclusions The sympathetic nerve in intracranial internal carotid artery system has complex course and adjacent relationship and high variability.The microanatomical study of the sympathetic nerve system can reduce injury from intracranial surgery.