枕正中入路相关静脉的显微解剖及其临床意义

Microsurgical anatomy of the veins related to midline suboccipital approach and its clinical significance

目的对枕下后正中入路相关静脉的显微解剖研究为临床在后颅窝病变手术中减少静脉损伤和减轻术后并发症提供形态学依据。方法利用20具成人尸头标本,动、静脉分别用红蓝色乳胶灌注,在显微镜下模拟枕下后正中入路,观察与此入路密切相关的静脉及其的属支,并对其进行统计和测量相关的数据。结果小脑下蚓静脉和小脑半球下静脉出现率100.0%,小脑延髓裂静脉出现率87.5%,小脑下脚静脉出现率77.5%,延髓后正中静脉出现率55.0%,小脑延髓池静脉出现率35.0%。结论枕下后正中入路相关静脉及其属支的构成复杂,变异大,提高对静脉显微解剖学的认识,可减少术中不必要的出血和降低术后并发症的发生。

Objective To explore the microsurgical anatomy of the veins related to midline suboccipital approach in order to provide the morphological evidence for the protection of veins and reduce the post-operative complications in the treatment of lesions in the posterior fossa.Methods Twenty adult cadaveric heads were perfused with red latex in artery and blue latex in vein for simulating the median posterior suboccipital approach.Veins and its tributaries related this approach were observed and measured under microscope.Results The appearance rate of inferior vermian veins and inferior hemispheric veins were 100.0%;the appearance rate of vein of the cerebellomedullary fissure was 87.5%;the appearance rate of vein of the inferior cerebellar peduncle was 77.5%;the appearance rate of the median posterior medullary vein was 55.0%;the appearance rate of the cerebellomedullary cistern vein was 35.0%.Conclusion The microsurgical anatomy of the veins related to midline suboccipital approach is intricate and highly variable.More knowledge of the veins may be helpful for reducing intra-operative bleeding and post-operative complications.