【摘要】 目的依照翼点锁孔入路探讨前交通动脉复合体的形态学特点,从而为利用该入路手术处理与前交通复合体相关的疾患提供解剖学基础。方法模拟翼点锁孔入路手术操作,在手术显微镜下对15例(30侧)福尔马林固定的国人成人湿性头颅标本进行解剖,观察前交通动脉复合体的显露情况,并进一步地对前交通动脉复合体各组成部分进行形态学观察并获取相关数据。结果经翼点锁孔入路可完整显露前交通动脉复合体。大脑前动脉均由颈内动脉发出,与对侧大脑前动脉借前交通动脉相接。Heubner回返动脉为大脑前动脉水平段发出的穿通动脉中最粗大的血管,其起点多位于近侧3 mm及远侧3 mm范围内。在大脑前动脉水平段3～5 mm及其中1/3段少有穿通支发出。大脑前动脉、前交通动脉及其分支的外径、长度及其起源均存在众多差异。结论利用翼点锁孔入路手术治疗与前交通动脉复合体有关的疾患具有可行性,术者在术前必须充分把握该复合体复杂的解剖学特征。大脑前动脉水平段近侧3～5 cm及其中1/3段可作为前交通动脉瘤手术时临时阻断的部位。更多还原

【Abstract】 Objective To explore the morphological characteristics of the anterior communicating artery complex(ACoAC)through the pterional keyhole approach,in order to provide the anatomic basis for the treatment of diseases related to the ACoAC.Methods Fifteen adult cadaver heads were dissected through the pterional keyhole approach,and the bilateral ACoAC was exposed and observed under a microscope.The morphological characteristics of the ACoAC and its perforating branches were studied.Results The ACoACs were exposed sufficiently through the pterional keyhole approach.The anterior cerebral artery(ACA)originated from the internal carotid artery and connected by the anterior cerebral communicating artery(ACoA)to contralateral ACA.The recurrent artery of Heubner was the thickest branch of the ACA-A1 segment and the location of its origin was in the range of 3 cm proximally to 3 cm distally.Few perforating arteries were found within 3～5 mm proximally and middle 1/3 of the ACA-A1 segment.Many variations were found in the diameter,length and origin of the ACA,ACoA and their perforating branches.Conclusion It is feasible to treat the diseases related to the ACoAC by the microsurgery via the pterional keyhole approach.The complicated morphological features of the ACoAC should be mastered sufficiently before the operation.The two positions located within 3-5 cm proximal to A1 segment and middle 1/3 portion of A1 segment can be used to transiently block for ACoA aneurysms.更多还原