Fetuslarda plexus brachialis oluşumuna katılan yapıların morfometrik analizi ve morfolojik varyasyonların araştırılması
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Dosyalar
Tarih
1999
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışma ikinci trimestr 75 ve üçüncü trimestr 25 adet olmak üzere toplam 100 fetusda gerçekleştirildi. İki taraflı yapılan diseksiyonlarda toplam 200 adet plexus brachialis incelendi. Diseksiyon sırasında lup ve mikroskop kullanılarak, normal ve morfolojik varyasyon gösteren plexus brachialisler (PB) tespit edildi. PB'i oluşturan elemanların uzunluk ve kalınlıkları kumpas yardımı ile ölçülerek fotoğrafları çekildi ve şematik çizimleri yapıldı. Veriler SPSS programında (Windows için 8.0) Pearson korelasyon testi ve Student t-testi ile istatistiksel olarak değerlendirildi. Yapılan çalışmada 93 adet normal (5., 6., 7., 8. cervical ve 1. thoracal spinal sinirlerin katılımından oluşan plexus brachialis) olarak değerlendirilen ve 107 adet morfolojik varyasyon gösteren plexus brachialis tespit edildi. 51 plexusda C4'den Cs'e katılım, 5 plexusda T2'den Ti 'e katılım, 1 plexusda hem C^den Cs'e hemde T2'den Ti 'e katılım gözlendi. 50 plexusda ise n. spinalis ramus ventralis seviyesinde katılıma rastlanmadı. Bu katılımlar dışında 22 adet PB'de truncuslara ait, 46 adet PB'de truncuslann divisyonlanna ait ( en sık TMDV'de olmak üzere), 20 adet fasciculus 'lara ait ve 24 adet terminal dallara ait morfolojik varyasyona rastlandı. Çalışmada morfolojik varyasyonlar kızlarda ve sağ tarafta daha fazla sıklıkla izlendi. Uzunluk ölçümleri açısından kız ve erkek arasında Cg, Ti, TS ve TM'un ve kalınlık açısından sağ ve sol arasında TIDD'un ortalamalarında anlamlı farklılığa rastlanırken, diğer parametrelerin ortalamaları arasındaki farkın istatistiksel açıdan anlamlı olmadığı gözlendi. Literatürdeki verilerle karşılaştırılarak tartışıldı. Bu bulguların fetal hayatta periferik sinir sistemi gelişimi hakkında ve konuyla ilgili cerrahi uygulamalarda pratik açısından yararlı olabileceği ve teşhis ve tedavide çıkabilecek komplikasyonlar açısından bölgenin anatomik özelliğinin bireylere göre göz önünde bulundurulmasının gerekli olduğu kanaatine varıldı.
This study was carried out in 100 fetuses (75; 2nd trimester, 25; 3rd trimester). In determination of the morphological variations, totally 200 brachial plexus were evaluated under examination stereomicroscope. After bilateral fine dissection, to perform morphometric studies, the thickness and/or length of the each part that contribute to the formation of the brachial plexus were measured by calipers. Photographs of the brachial plexuses were taken after dissection and then the illustrations the morphological variations were drawn from these photographs. Data was statistically analysed by Pearson correlation and Student t-tests using SPSS software (for windows 8.0). In this study, 93 fetuses were decided as normal (the brachial plexus consist of the 5th, 6th, 7th, 8th cervical nerves and 1st thoracic nerve), and the others (107 fetuses) having morphological variations in the brachial plexus structure classified into four group regarding the variations; the connection from 4th to the 5th cervical nerve in 51 brachial plexuses, from 1st to the 2nd thoracic nerve in 5 plexuses, both connection in the same fetus in 1 plexus, and have no connection in the root part of plexus in 50 plexuses. However, there were morphological variations in the other parts of the plexus as follows: in 22 cases within trunks, in 46 plexuses within the divisions (It was observed most frequently in the anterior division of middle trunk), in 20 plexuses in the fasciculus formation, and in the terminal branches of 24 plexuses. The morphological variations was observed more frequently in female and right plexuses (in female 56%, in male 44% - right 58%, left42%). The mean value of the length of the 8th cervical, 1st thoracic, upper trunk and middle trunk showed statistically significant difference between female and male. The mean value of the thickness of the posterior division of lover trunk showed statistically significant difference between right and left side. There was no significant difference in other parameters. Regarding to the correlation values between the age and the measured parameters, the growth rate of the each part that contribute to the formation of the brachial plexus, was higher in 2nd trimester than in 3rd trimester. The reported results may provide useful information to the fetal development of peripheral nervous system, and in the diagnostic and therapeutic approach of paediatric surgeons for preventing complications.
This study was carried out in 100 fetuses (75; 2nd trimester, 25; 3rd trimester). In determination of the morphological variations, totally 200 brachial plexus were evaluated under examination stereomicroscope. After bilateral fine dissection, to perform morphometric studies, the thickness and/or length of the each part that contribute to the formation of the brachial plexus were measured by calipers. Photographs of the brachial plexuses were taken after dissection and then the illustrations the morphological variations were drawn from these photographs. Data was statistically analysed by Pearson correlation and Student t-tests using SPSS software (for windows 8.0). In this study, 93 fetuses were decided as normal (the brachial plexus consist of the 5th, 6th, 7th, 8th cervical nerves and 1st thoracic nerve), and the others (107 fetuses) having morphological variations in the brachial plexus structure classified into four group regarding the variations; the connection from 4th to the 5th cervical nerve in 51 brachial plexuses, from 1st to the 2nd thoracic nerve in 5 plexuses, both connection in the same fetus in 1 plexus, and have no connection in the root part of plexus in 50 plexuses. However, there were morphological variations in the other parts of the plexus as follows: in 22 cases within trunks, in 46 plexuses within the divisions (It was observed most frequently in the anterior division of middle trunk), in 20 plexuses in the fasciculus formation, and in the terminal branches of 24 plexuses. The morphological variations was observed more frequently in female and right plexuses (in female 56%, in male 44% - right 58%, left42%). The mean value of the length of the 8th cervical, 1st thoracic, upper trunk and middle trunk showed statistically significant difference between female and male. The mean value of the thickness of the posterior division of lover trunk showed statistically significant difference between right and left side. There was no significant difference in other parameters. Regarding to the correlation values between the age and the measured parameters, the growth rate of the each part that contribute to the formation of the brachial plexus, was higher in 2nd trimester than in 3rd trimester. The reported results may provide useful information to the fetal development of peripheral nervous system, and in the diagnostic and therapeutic approach of paediatric surgeons for preventing complications.
Açıklama
Anahtar Kelimeler
Brakiyal pleksus, Brachial plexus, Fetüs, Fetus
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Sayı
Künye
Uysal, İ. İ. (1999). Fetuslarda plexus brachialis oluşumuna katılan yapıların morfometrik analizi ve morfolojik varyasyonların araştırılması. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
