【摘要】 目的:为神经内窥镜下侧脑室手术相对安全的穿刺路径提供解剖学依据。方法:模拟神经内窥镜手术,分别从侧脑室的额角、颞角、三角区和枕角4种入路对固定后的成人颅脑标本进行解剖观测,分析比较不同手术入路的优劣。结果:E2点与脑膜中动脉和大脑上静脉毗邻;N1～N3点与脑膜中动脉毗邻;N4点的体表定位点位于颞上回,深部正对颞横回;Z1～Z3点穿经视辐射,Z3点距角回最近,Z5、Z6与大脑上吻合静脉毗邻。结论:(1)额角入路相对于来说比较安全,只是定位准确,在穿刺过程中不会伤及血管和重要的神经中枢;(2)经颞角入路进行穿刺时,有损伤脑膜中动脉的危险;(3)三角区入路不常用,并且易损伤听辐射;(4)枕角入路利于手术中多部位的探查。更多还原

【Abstract】 Objective:To provide anatomical basis for neuroendoscopes surgery in the lateral ventricle of a safe operative approach.Methods:The structures of lateral ventricle of adult formalin-fixed cadaveric head specimens were observed and measured by simulating endoscopic surgery.Analyze and compare the advantages and disadvantages of the four operative approaches:the anterior horn approach,the inferior horn approach,the triangular area approach and the occipital horn approach.Results:E2 was adjacent to the middle meningeal artery and the superior cerebral vein;N1-N3 were also adjacent to the middle meningeal artery;The anchor point on the body surface of N4 was on the superior temporal gyrus where the gyri temporales transversi just was in the deep part;The optic radiation was punctured by Z1-Z3,Z3 was the nearest to the angular gyrus,and Z5 and Z6 were adjacent to the superior anastomotic vein of the brain.Conclusion:(1)The anterior horn approach is relatively safe with little lesion to the blood vessel and the nerve center on condition that the location on the body surface is accurate;(2)It is possible to impair the middle meningeal artery from the inferior horn approach;(3)The triangular area approach was seldom used for its risk to impair the acoustic radiation;(4)It is expedient of cornu occipitale approach to explore several regions in the operation.更多还原