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。

Microsurgical Anatomical Study of the Anterior CommunicatingArtery Complex

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） A1 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 A1 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.