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显微外科解剖

显微外科解剖的相关文献在1989年到2021年内共计115篇,主要集中在基础医学、外科学、肿瘤学 等领域,其中期刊论文111篇、会议论文4篇、专利文献73837篇;相关期刊56种,包括解剖与临床、解剖学杂志、中华显微外科杂志等; 相关会议4种,包括中华中青年神经外科交流协会第二届学术大会、中华医学会第四次全国美容外科学术大会、2006山东国际神经外科学术论坛等;显微外科解剖的相关文献由336位作者贡献,包括朱贤立、党瑞山、卢亦成等。

显微外科解剖—发文量

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论文:111 占比:0.15%

会议论文>

论文:4 占比:0.01%

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论文:73837 占比:99.84%

总计:73952篇

显微外科解剖—发文趋势图

显微外科解剖

-研究学者

  • 朱贤立
  • 党瑞山
  • 卢亦成
  • 杨雷霆
  • 肖绍文
  • 袁贤瑞
  • 黄玮
  • 孙晓峰
  • 廖建春
  • 韩卉
  • 期刊论文
  • 会议论文
  • 专利文献

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    • 花先; 丁冉; 柯俊仪; 丁自海; 刘鹏; 郑雪峰
    • 摘要: 目的 为颏下皮瓣移植提供更精准的颏下动脉走行、分支、分布、动脉网构筑及皮瓣切取范围的显微外科解剖学资料.方法 2015年3月至2020年3月,采用36例成人头颈部新鲜标本制成血管铸型标本(72侧),向双侧颈外动脉内注入红色丙烯晴-丁二烯-苯乙烯(ABS)填充剂,观测颏下动脉的走行、分支、分布和动脉网的构筑特点.结果 颏下动脉由面动脉距下颌骨下缘(1.50±0.50)cm处发出,起始处直径(1.50±0.85)(0.6~2.3)mm.颏下动脉主干长(5.5±0.5)cm,沿下颌骨下缘稍后方向前走行,沿途发出(9.0±3.0)(7?13)条分支,直径0.1~0.5 mm,主要分布于颏下区皮肤和浅筋膜.主干行至距下颌骨中线3.0 cm范围内分为升支、水平支和降支,升支1~5条,向上越过下颌骨下缘与下唇弓分支吻合,或参与构成下唇弓;水平支1~2条,向内又分为数支与对侧分支吻合;降支1~3条,行向后下方,与舌动脉和甲状腺上动脉的分支吻合.在颏下区,颏下动脉各分支间及与周边动脉的分支间相互吻合,构筑成密集的1~3层颏下动脉网,主网区范围约7.0 cmx5.0 cm,网内主要血管直径0.1~0.2 mm.结论 颏下动脉主干较长,分支较多,分支间吻合丰富,构成密集的颏下动脉网,为颏下皮瓣提供了足够的蒂长、丰富的血供和切取面积,该皮瓣既可进行游离移植,也可转位移植.颏下皮瓣最佳切取部位为动脉网近中线区,切取面积以7.0 cmx5.0 cm为宜.
    • 王涵; 王玉海
    • 摘要: 目的:为经口入路至颈静脉孔区处理颈静脉孔区病变提供解剖学依据.方法:在显微镜下对经彩色乳胶灌注成人尸头湿标本的颈静脉孔区经口入路进行解剖,观察路径中组织结构的暴露情况和走行关系,定位相关解剖标志,记录测量数据.结果:尸头标本的颈静脉孔区颅外部分均显露良好,可暴露自颈动脉嵴内侧至枕骨髁后外侧缘和中线至茎突根部区域,磨除颈静脉孔前内侧骨质后,可观察到岩下窦、Ⅸ~Ⅺ神经在孔内走行和毗邻关系.测量相关参数,枕髁前缘距舌下神经管外口前缘(12.47±1.49) mm;舌下神经管外口上缘距颈动脉嵴内侧(9.90±1.40) mm等.结论:经口入路可较好的暴露颈静脉孔区前内侧,以枕髁和颈动脉嵴为解剖标志,有助于避免此入路处理颈静脉孔区病变时对重要血管和神经的损伤.%Objective:To provide anatomical basis for the treatment of jugular foramen lesions by microsurgical anatomy through the transoral approach to the jugular foramen.Methods:Fifteen (30 sides) adult cadaveric head specimens perfused with colored latex were used to investigate the microsurgical anatomy of the transoral approach to the jugular foramen with the help of surgical microscope,so as to observe the structure in this approach,locate the anatomic markers and measure the relevant data.Results:The extracranial part of jugular foramen was well exposed in the fifteen cadaver heads,and medial anterior lesions in jugular foramen could be exposed from carotid ridge to lateral border of occipital condyle and centerline to the styloid process.After removing the anteromedial bone of the jugular foramen,the inferior petrosal sinus,Ⅸ-Ⅺ nerve walking relationship in the jugular foramen could be observed.The distance was (12.47+1.49) mm from anterior edge of the occipital condyle to the anterior edge of the hypoglossal canal external opening;the distance was (9.90+ 1.40) mm from superior edge of the hypoglossal canal external opening to the carotid ridge.Conclusion:The anterior medial area of jugular foramen could be well exposed through the transoral approach,and the occipital condyle and carotid ridge can be used as anatomic markers,which can protect the vital nerves and vascular structures from injury by this approach.
    • 代飞虎; 董吉荣
    • 摘要: 目的:研究面神经脑桥小脑三角段与周围神经血管等结构的解剖关系,为显微血管减压术治疗面肌痉挛提供显微解剖参数.方法:成人头颅标本,经口咽至斜坡暴露脑干腹侧面,经脑干腹侧面对面神经脑桥小脑三角段及周围诸结构进行显微测量.结果:面神经与脑桥分离点至面神经实际出入脑干处、内耳门距离为(6.08±0.85) mm、(11.55±1.11) mm;前庭蜗神经与脑桥分离点至前庭蜗神经实际入脑干处、内耳门距离为(6.86±0.91) mm、(10.20±1.19) mm.面神经实际出入脑干处、面神经与脑桥分离点位于舌咽神经出入脑干处、前庭蜗神经与脑桥分离点、绒球内侧缘内侧,是面神经减压重要区域.面神经实际出入脑干处至舌咽神经出入脑干处、前庭蜗神经与脑桥分离点、绒球内侧缘距离分别为(2.12±0.44) mm、(6.32±0.76) mm、(5.65±0.99) mm.面神经与桥脑分离点至舌咽神经出入脑干处、前庭蜗神经与脑桥分离点、绒球内侧缘距分别为(5.95±0.70) mm、(1.18±0.53) mm、(2.98±0.73) mm.结论:面神经实际出入脑干处、面神经与脑桥分离点与血管压迫关系密切,空间位置较深,是术中减压和避免损伤的操作重点.舌咽神经、前庭蜗神经、绒球可作为术中快速定位面神经脑桥小脑三角段进行减压的重要标志.%Objective:To study the anatomical relationship between cerebellopontine angle segment of facial nerve and surrounding neurovascular structures and to offer anatomic parameters for treating hemifacial spasm with microvascular decompression.Methods:Fifteen adult head specimens were exposed to the ventral surface of the brainstem through oropharynx to clivus.Microscopic measurements were made on the sections and structures around the cerebellopontine angle segments of the facial nerve.Results:The distance from root detachment point of facial nerve to root exit point of facial nerve,internal acoustic pore were (6.08±0.85) mm,(11.55 ± 1.11) mm.The distance from root detachment point of vestibulocochlear nerve to root enter point of vestibulocochlear nerve,internal acoustic pore were (6.86±0.91) mm,(10.20±1.19) mm.The root exit point and root detachment point of facial nerve were important regions of decompression of facial nerve,which were located in the inner side of root exit point of glossopharyngeal nerve,root detachment point of vestibulocochlear nerve,inside edge of flocculus.The distance from root exit point of facial nerve to root exit point of glossopharyngeal nerve,root detachment point of vestibulocochlear nerve,inside edge of flocculus were (2.12±0.44) mm,(6.32±0.76) mm,(5.65± 0.99) mm,respectively.The distance from root detachment point of facial nerve to root exit point of glossopharyngeal nerve,root detachment point of vestibulocochlear nerve,inside edge of flocculus were (5.95 ± 0.70) mm,(1.18±0.53) mm,(2.98±0.73) mm,respectively.Conclusion:The root exit point of the facial nerve and the root detachment point of facial nerve are the focal point of decompression and can avoid the damage during operation for it closely related to the vascular compression and deep space.Glossopharyngeal nerve,vestibulocochlear nerve,and flocculus are important signs for fast positioning of cerebellopontine angle segment of facial nerve to decompression in the operation.
    • 沈立锋; 刘亦杨; 饶利兵; 郭峭峰; 黄凯; 张展; 向长河; 黄文华; 张春
    • 摘要: 目的 观察腓动脉和胫后动脉穿支显微解剖特点,应用腓动脉或胫后动脉穿支蒂螺旋桨皮瓣修复小腿远端及足踝部软组织缺损创面,探讨其并发症防治措施. 方法 2011年3月至2011年4月,对5具新鲜尸体共10侧小腿标本,用红色乳胶灌注腘动脉、蓝色乳胶灌注静脉,解剖并观察统计腓动脉和胫后动脉穿支数量、长度、走行角度、血管直径和动静脉伴行情况等指标;从2011年6月至2013年6月,对47例小腿远端以及足踝部软组织缺损病例用穿支蒂螺旋桨皮瓣修复,观察临床疗效并统计并发症发生率,探讨并发症防治的方法. 结果 腓动脉和胫后动脉共发出穿支92支,其中有2条伴行静脉的有52支,有1条伴行静脉的有37支,伴行静脉缺如的1支,还有2支腓动脉穿支穿深筋膜后共用1条伴行静脉进入皮肤.腓侧在距外踝(3.0±1.0)cm和(8.0±2.0)cm处、胫侧在距内踝(5.0±1.0)cm和(8.0±1.0)cm处有较为恒定的穿支血管穿出深筋膜进入皮肤.36例腓动脉穿支蒂螺旋桨皮瓣其穿支穿出深筋膜距离外踝距离6~ 18 cm,平均10.1cm,其中24例穿支位置在距外踝(8.0±2.0) cm范围内;11例胫后动脉穿支穿出深筋膜距离内踝6~18 cm,平均9.5 cm,其中有6例穿支位置在距内踝(8.0±1.0) cm范围内;并发症包括1例皮瓣下积血,1例感染,1例供区植皮坏死,13例静脉回流障碍,其中4例出现远端部分坏死. 结论 以腓动脉穿支和胫后动脉穿支为蒂的螺旋桨皮瓣外表美观,操作简单,是修复小腿远端及足踝部创面的首选方案之一;腓动脉在距外踝(8.0±2.0) cm范围内穿出深筋膜的穿支恒定,长度以及血管口径适合,是设计螺旋桨皮瓣血管蒂的最佳选择.%Objective The research expects to investigate the gross anatomical characteristics of the perforating branches of posterior tibial artery and peroneal artery and repair the soft tissue defect in distal termination of leg and around the foot and ankle by using the perforator pedicled propeller flap of the two arteries.The prevention measures for the complications were also explored.Methods From March,2011 to April,2011,concerning the specimens of 10 sides of 5 fresh cadavers,red latex was perfused into the popliteal arteries while blue latex was perfused into the veins.Then,after anatomization,the indexes,including the number,length,orientation angles,vessel diameter and the concomitant relationship between the artery and vein,of the perforating branches of posterior tibial artery and peroneal artery were recorded.From June,2011 to June,2013,47 cases with soft tissue defect in distal termination of leg and around the foot and ankle were treated by repairing the perforator pedicled propeller flap.On this basis,the clinical effect was observed and the complication rate was calculated so as to study the prevention methods for the complications.Results The perforating branch occurred in 92 posterior tibial and peroneal arteries.Among them,each of 52 arteries had 2 concomitant veins,37 presented 1 concomitant vein,and 1 had no concomitant vein;the perforating branches of 2 peroneal arteries entered into the skin by sharing 1 concomitant vein after perforating deep fascia.On fibular side,at (3.0 ± 1.0) cm and (8.0 ± 2.0) cm from lateral malleolus,on tibial side,at (5.0 ± 1.0) cm and (8.0 ± 1.0) cm from medial malleolus,constant perforating vessels of peroneal artery went into the skin after perforating deep fascia.Concerning the perforator pedicled propeller flaps of 36 peroneal arteries,the perforating branches were 6 to18 cm and 10.1 cm on average to the lateral malleolus after perforating deep fascia.Among them,the perforating branch of 24 cases located in the range of (8.0 ± 2.0) cm to the lateral malleolus;the perforating branches of 11 posterior tibial arteries were 6 to18 cm with an average of 9.5 cm to the medial malleolus,after perforating deep fascia;the perforating branches of 6 cases were in the site (8.0 ± 1.0) cm from the medial malleolus.The complications included 1 case of hematocele under flap,1 case of infection,1 case of necrosis of skin graft of donor site,and 13 cases of venous drainage disturban-ce,among which,4 cases were suffered with distal flap necrosis.Conclusion The texture and color of propeller flap with a beautiful surface were similar to the recipient area.The harvest of flap was simple to perform without the necessity to match the vessel.Propeller flap presents satisfied clinical effect and is one of the preferred alternatives for repairing the defect in distal termination of leg and around the foot and ankle.In the range (8.0 ± 2.0) cm from lateral malleolus,the perforating branch of peroneal artery was constant after perforating deep fascia with suitable length and vessel diameter.Therefore,peroneal artery is the optimal choice for designing pedicled propeller flap.
    • 毛仁玲; 刘晓东; 杨德林; 徐启武
    • 摘要: 目的 为临床提供海绵窦显微外科解剖学基础,避免海绵窦手术中颈内动脉及分支的损伤.方法 在手术显微镜下对23例(46侧)成人头颅标本进行解剖、观察、测量和拍摄.结果 颈内动脉海绵窦段在海绵窦内大致呈“~”形,位置固定,其主要分支脑膜垂体干、海绵窦下动脉和垂体被膜(McConnell)动脉的出现率分别为100%、86.9%和17.4%.岩舌韧带、岩尖、后床突、颈动脉沟、前床突等解剖结构与颈内动脉存在相对固定的解剖关系.海绵窦内颅神经的血液供应主要来源于海绵窦下动脉及脑膜垂体干.结论 颈内动脉的脑膜垂体干的出现率高、位置相对固定,在临床手术的定位、记录和分段中可作为标志点.从颈内动脉的近端到远端,相对固定的5个解剖结构在海绵窦手术中可作定位标志.手术在游离海绵窦内颅神经时,应尽可能先在颈内动脉找寻脑膜垂体于和海绵窦下动脉,循其主干到分支,明确找到供血动脉后再操作.
    • 徐达传
    • 摘要: 皮瓣外科在临床应用的基本原则是供区损伤最小化、受区功能最大化.由于穿支皮瓣能最大限度满足上述条件,因此发展迅速.本文重点总结穿支皮瓣近年在基础与临床应用方面的最新进展.基础研究方面包括:穿支皮瓣3D可视化研究、穿支体间choke vessels在体动态研究;临床应用方面包括:穿支血管的术前影像导航技术、带蒂穿支皮瓣、游离穿支皮瓣、自由穿支皮瓣、穿支微型皮瓣和特殊形式穿支皮瓣以及影响穿支皮瓣成活的血管因素等.
    • 曹刚; 涂汉军; 张力; 黄宽明
    • 摘要: 目的:对前床突(anterior clinoid process,ACP)、磨除前床突后颈内动脉(internal carotid artery,ICA)床突段进行解剖观察和测量,为临床显微神经外科手术治疗该区域的血管、肿瘤、神经等疾病提供解剖学依据。方法:利用15例(30侧)10%福尔马林固定的成人尸头湿标本,对前床突、颈内动脉床突段进行显微解剖,观察和测量前床突、颈内动脉床突段及其周围裂隙和相互之间的关系。结果:前床突长(9.62±0.23)mm、宽(12.19±0.32)mm、厚(5.31±0.18)mm;床突尖动脉距前床突尖前为(3.70±0.80)mm,出现率为16.7%(5侧),1侧在尖部,3侧在正下方,1侧在内侧,直径为(0.70±0.20)mm;前床突气化率为10%。颈内动脉床突段起于近侧硬膜环,止于远侧硬膜环,床突段长(5.14±0.74)mm。结论:磨除前床突是治疗颈内动脉眼动脉段动脉瘤和颈内动脉床突段动脉瘤的特殊技术和难点所在,磨除前床突时如果前床突气化,注意填塞气房,防止脑脊液漏。
    • 张学基; 张崇岳; 杨勇; 黄宗涛; 罗克政
    • 摘要: Objective To study the microsurgical anatomy of facial nerve from exit point of brainstem to inside of temporal bone and relationship structure in order to provide anatomic parameters for facial nerve microvacular decompression (MVD) and cerebellar pontine angle (CPA) area operation through retrosigmoid approach.Methods The CPA area segment of facial nerve and its relationship struetures were observed by operative microscope on 10 adults cadaveric heads via the key hole restro sigmoid approach.The data of 128 patients operated by facial nerve MVD were observed and analyzed.Results Cadaveric heads anatomy showed the number of radix nervi facialis that was oppressed or touched by the blood vessel around was 9 side (9/20),including anterior inferior cerebellar artery (AICA) 5 side,posterior inferior cerebellar artery (PICA) 2 side,vertebral artery (VA) 1 side and multivessel 1 side.Operation information showed the culprit blood vessel of hemifacial spasm was the anterior inferior cerebellar artery (79,61.72%),posterior inferior cerebellar artery (21,16.41%),vertebral artery (6,4.69%) and multivessel (22,17.18%).It located mostly in pontomedullary sulcus.Conclusion The microsurgical anatomy of facial neurovascular bundle especially in pontomedullary sulcus segement and its adequately exploration in operation are the key points to achieve consistent success in facial nerve MVD.%目的 探讨面神经自脑干发出处至颞骨内侧段及其毗邻结构的显微解剖,为枕下乙状窦后入路面神经微血管减压术(MVD)及桥脑小脑角(CPA)区手术提供显微解剖相关资料.方法 对用福尔马林固定的成人尸头标本10例20侧(男性6例,女性4例),模拟枕下乙状窦后锁孔入路手术方法,显微技术解剖CPA区域面神经及其毗邻神经血管等结构,进行观察和测量;对128例面神经MVD手术资料进行观察、整理和分析.研究面神经血管束的组成与变异,并将解剖标本与手术所见进行对比分析.结果 尸头解剖:面神经根与毗邻血管压迫或接触9侧(9/20),其中:小脑前下动脉(AICA)5侧,小脑后下动脉(PICA)2侧,椎动脉(VA)1侧,多支血管1侧;手术资料:半侧面肌痉挛(HFS)的责任血管绝大多数位于桥脑延髓沟,其中AICA 79例(61.72%);PICA 21例(16.41%);椎-基底动脉6例(4.69%);多支血管22例(17.18%).结论 面神经血管束,特别是其桥脑延髓沟段的显微外科解剖和术中充分暴露是面神经MVD手术成功的关键.
    • 付爱军; 朱军; 李建珉; 程爱国; 陈通; 刘清军; 刘刚; 张云鹤
    • 摘要: ①目的 探讨颅颈交界区各结构毗邻关系,为临床安全处理颅颈交界区病损提供显微解剖学依据.②方法 将15具(30侧)国人成年连颈尸体头颅湿性标本在手术显微镜下进行解剖观察和测量.③结果 枕下段椎动脉测量左右两侧直径有显著性差异,以左侧大于右侧为主.上、下枕下三角是保护椎动脉第三段的重要标志.头外侧直肌是确认颈静脉孔后外侧缘的标志、二腹肌后腹是保护面神经的标志.枕髁后1/3~1/2的磨除可获得对枕骨大孔腹侧和腹外侧的满意显露.颈静脉结节的磨除对于增加枕骨大孔上方病变的显露非常重要.④结论 颅颈交界区结构毗邻关系复杂,掌握该区的显微解剖特点和解剖学标志,可增加该区手术的安全性.枕髁和颈静脉结节的磨除可增加手术视野.
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