椎-基底动脉的应用解剖学研究

The applied anatomy study of vertebral basilar artery

目的观测椎-基底动脉及其主要分支的行程、起始处外径以及夹角，为临床高位颈椎手术和介入术提供解剖形态学依据。方法大体逐层解剖和注入过氯乙烯标本头颈部，观察椎-基底动脉的起始处外径及夹角、走行、分支、分布、吻合及伴行情况。结果锁骨下动脉与椎动脉夹角左侧（91．70±0．90）°，右侧（115．80±1．60）。（P〈0．05）。2例标本小脑下后动脉从迷走、舌咽神经根上方走行占14．1％。小脑下后动脉与椎动脉夹角左侧（118．60±3．70）°，右侧（77．60±7．90）°（P〈0．05）。小脑前下动脉与面神经根接触占27．6％，小脑下前动脉与基底动脉夹角左侧（91．60±2．40）°，右侧（27．20±2．70）°（P〈0．05）。小脑上动脉与三叉神经根接触的比例为35．5％。小脑上动脉与基底动脉夹角左侧（89．50±4．10）°，右侧（100．20±4．90）°（P〈0．05）。大脑后动脉与基底动脉夹角左侧（93．90±3．40）°，右侧（130．80±3．20）°（P〈0．05）。结论椎动脉、小脑下前动脉起始处外径以及椎-基底动脉主要分支左、右起始处夹角呈不对称性，对实施血管介入和颈椎外科等具有临床指导意义。

Objective To observe the vertebrobasilar artery and its branch courses, diameters and the included angles in the starting part, offering morphological basis for clinic intervention and vascular im- age. Methods Layer by layer dissecting head, neck and chest of nine adult specimens affused with red la- tex, and after affused carotid artery with red latex, the origin, course, branches, distribution, anastomosis, and accompanying of the vertebrobasilar artery were observed in three normal adult corroded specimens. Resuits The degree of the left included angle between subclavian artery and vertebral was （ 91.70±0.90 ）° and that of the right one was （ 115.80±1.60）° （ p 〈 0.05 ）. A percentage （ 14. 1% ） of them contacted with vagus and glosssopharyngeal nerve. The degree of the left included angle between posterior eerebal lower artery and vertebral artery was （ 118.60±3.70）° and that of the right one （ 77.60±7. 90）°. A percentage （27.6%） of itself contacted or pressed by root of facial nerve. The degree of the included angle on the left side between anterior cerebellar lower artery and brobasilar artery was （91.60±2.40）° and that of the right one was （27. 10±2. 70）°（ P 〈0. 05）. The degree of the left included angle between posterior cere- bral artery and basilar artery was （93.90±3.40）° and that of its right one was （ 130. 80±3.20）° （ P 〈 0. 05 ）. Conclusions Both vertebral artery in every part out of skull and the data of the each branch pipe diameter, the starting included angle of vertebrobasilar artery had statistical significance, which should select personalized catheter or operation method in endovaseular intervention or eranioeervical surgery.