壳核动脉的显微解剖研究及其临床意义.doc

壳核动脉的显微解剖研究及其临床意义 管 勇1? 吕少萍2 孙 淼1 余发昌3 徐志明1 刘 伟1 丰育功1 【摘要】 目的 观察壳核动脉的解剖学特征，为高血压脑出血好发于壳核的原因分析提供形态学依据。方法 采用镜下解剖和脑血管铸型方法，对60侧脑标本、6例脑血管铸型标本壳核动脉的形态学特点进行了观察。结果60侧大脑半球共观察到470支壳核动脉，平均每侧7.8±2.6支。470支壳核动脉80.6%来源于大脑中动脉；17.9%来源于大脑前动脉；1.5%来源于脉络膜前动脉。壳核动脉行程迂曲，在穿入壳核时尚形成弓状、环状弯曲，其直接形成直径?0.10 mm分支情况亦明显高于基底核区其它结构的供血动脉（?2值=61.1912，P＜0.01），且76%的壳核动脉起于大脑中动脉分叉处2mm范围内。结论 壳核动脉的起源、行程以及其分支发出形式的解剖特点决定了壳核动脉高血压下易破裂出血。 【关键词】脑出血；壳核；脑动脉；解剖学 MICROSURGICAL ANATOMY AND CLINICAL SIGNIFICANCE OF THE PUTAMINAL ARTERIES GuanYong1 Lv Shaoping2 Sun Miao1 Yu Fachang3 Xu Zhiming1 Liu Wei1 Feng Yugong1 1Department of Neurosurgery , the Affiliated Qingdao municipal Hospital of the Qingdao University Medical College, Qingdao 266011 China; 2Department of Neurology, NO.2 Affiliated Hospital of the Qingdao University Medical College; 3Department of Anatomy, Kunming Medical College, Kunming 650031. 【Abstract】 Objective To supply the morphological basis for explaining the fact that hypertensive putaminal hemorrhage was more often happen than the other structures in the basal nuclei. Methods the technique of micro-anatomical and cerebral vascular cast. Results 470 putaminal arteries were discovered within 60 cerebral hemispheres , for an average of 7.8 arteries per hemisphere (range 6to 14 arteries). Based on their origin, these arteries were divided into three groups: 80.6% of the studied arteries arose from the middle cerebral artery (MCA). 17.9% originated from the anterior cerebral artery (ACA). 1.5% derived from the anterior choroidal artery (AChA). The putaminal arteries not only wound their way, but also formed a bow-shape or circularity, when they perforated into the cerebral. The frequency giving off directly the fourth branch was higher in the putaminal arteries than that in the other feeding arteries of striatum and internal capsule (P?0.01). Conclusion Putaminal Arteries are closely relevant to the cerebral hemorrhage, in the matter of their origin, route and branch. 【Key words】 cere