前交通动脉复合体的显微外科解剖研究

目的:通过手术显微镜对前交通动脉复合体及穿支进行解剖和测量,进一步熟悉和掌握该复合体的结构及毗邻血管的走行,为前交通动脉瘤手术提供解剖学依据.方法:用红色乳胶经颈内动脉对15例(30侧)福尔马林固定的湿性尸头进行灌注,然后在手术显微镜下对前交通动脉复合体进行解剖观测,所得结果用SPSS17.0软件进行统计分析.测量大脑前动脉A1和A2段、前交通动脉、Heubner回返动脉、A1段和前交通动脉穿支的长度、直径和各种形态变异.结果:未经选择的标本双侧A1发育无明显差异;术中对Heubner回返动脉、A1段穿支、前交通动脉穿支应仔细分辨加以保护;A1中1/3段穿支少,可作为前交通动脉瘤手术时临时阻断A1的部位;血管造影时前交通动脉不易看清与多种因素有关.结论:前交通动脉复合体复杂多变,熟悉前交通动脉复合体及穿支的解剖特点,对外科医生处理该区疾病至关重要.

Abstract：

Objective:To investigate the anatomy structure and adjacent vessels by investigating the anterior communicating artery complex and its perforating branches under an surgery microscope, in order to, to provide anatomical datas for anterior communicating aneurysms. Method: A total of 15 adult cadaveric heads (30 cerebral hemispheres) fixed with formalin were used, red latex was injected into internal carotid artery. Anterior communicating artery complexes were dissected, detected by surgery microscope.The results were analyzed with SPSS 17.0 statistical software. The lengthes, diameters and variations of the anterior cerebral artery(ACA)A 1 segment, A2 segment, anterior communicating artery (AComA), Heubner recurrent artery(HRA), perforating branches of A1 segment and AcomA were measured. Result:There were no statistically significant differences between two sides of A1 segment in length and diameter. HRA, perforating branches of Al segment and AComA should be carefully recognized and protected during the operation on anterior communicating aneurysms. The middle 1/3 of A1 segment which had less perforating branches was the best position for temporary occlusion during the operation on anterior communicating aneurysms. It is difficult to distinguish AComA in cerebral angiography. Conclusion: The anterior communicating artery complex was regarded as the most complex. Being familiar with the anatomy of the anterior communicating artery complex and the perforating branches enabled neurosurgeons to handle the diseases in this area efficiently.     

前交通动脉复合体的显微外科解剖研究

目的：通过手术显微镜对前交通动脉复合体及穿支进行解剖和测量,进一步熟悉和掌握该复合体的结构及毗邻血管的走行,为前交通动脉瘤手术提供解剖学依据。方法：用红色乳胶经颈内动脉对15例（30侧）福尔马林固定的湿性尸头进行灌注,然后在手术显微镜下对前交通动脉复合体进行解剖观测,所得结果用SPSS17.0软件进行统计分析。测量大脑前动脉A1和A2段、前交通动脉、Heubner回返动脉、A1段和前交通动脉穿支的长度、直径和各种形态变异。结果：未经选择的标本双侧A1发育无明显差异;术中对Heubner回返动脉、A1段穿支、前交通动脉穿支应仔细分辨加以保护;A1中1/3段穿支少,可作为前交通动脉瘤手术时临时阻断A1的部位;血管造影时前交通动脉不易看清与多种因素有关。结论：前交通动脉复合体复杂多变,熟悉前交通动脉复合体及穿支的解剖特点,对外科医生处理该区疾病至关重要。     

下丘脑室旁核胃动素对胃运动影响的探讨

目的 :研究下丘脑室旁核 (paraventricularnucleus,PVN)胃动素对胃运动调节的参与作用及机制。 方法 :应用免疫组织化学的方法检测室旁核内胃动素神经元的表达情况及室旁核与延髓迷走复合体 (dorsalvagalcomplex ,DVC)间的神经联系 ,应用室旁核内微量注入胃动素的方法观察清醒大鼠胃运动的变化。结果 :①下丘脑室旁核有胃动素免疫阳性细胞 ,在饥饿组和十二指肠灌酸组 ,阳性细胞数有明显增加 (P <0 .0 1)。②迷走背核注入辣根过氧化物酶 (horseradishperoxidase ,HRP) ,在室旁核发现HRP标记细胞 ,证实室旁核与DVC间的纤维联系。③清醒大鼠室旁核内微量注射胃动素可使胃运动的幅度和频率明显增加 (P <0 .0 5 ) ,切断双侧膈下迷走神经后 ,胃动素对胃运动的作用消失。结论 :下丘脑室旁核内胃动素可增强胃运动 ,其作用可能是通过下丘脑 延髓迷走复合体 迷走神经实现的     

听源性惊厥致P77PMC大鼠杏仁核内胆囊收缩素mRNA短暂性增加

铃声刺激诱发惊厥 ,原位杂交法检测遗传性听源性癫痫易感大鼠 (P77PMC)一次与多次惊厥发作对杏仁核内胆囊收缩素 (CCK)mRNA含量的影响。结果发现 :( 1)惊厥未发作组大鼠杏仁核单位面积内的CCKmRNA阳性神经元数 (No/ 0 0 1mm2 )较少 ,为 8± 1;( 2 )惊厥发作一次组大鼠杏仁核单位面积内CCKmRNA阳性神经元数显著增加 ,发作后 30min时达到峰值 ,为 5 8± 5 (P <0 0 1) ,但是 2h后迅速降为正常 ,为 9± 2 (P >0 0 5 ) ;( 3)惊厥多次发作组大鼠在惊厥发作后 30min时 ,CCKmRNA阳性神经元数亦显著增加 ,为 2 2± 3 (P <0 0 1) ,但明显低于惊厥发作一次组大鼠 (P <0 0 1) ,1h即恢复正常 ,为 9± 3 (P >0 0 5 )。结果表明 ,惊厥发作后P77PMC大鼠杏仁核内CCKmR NA含量呈现迅速而短暂增加的特点 ,表明CCKmRNA参与惊厥的急性发作过程 ,提示CCKmRNA在惊厥发作早期阶段发挥了重要的抗惊厥作用