脊髓体感与运动诱发电位术中联合监测的应用价值  

Application value of monitoring by combination of spinal somatosensory evoked potentials and motor evoked potentials during operation

作　　者：周晖[1] 赵瑛[1] 贺斌[1] 黄坚[1] 黄小风[2] 刘祖德[2] 黄晨光[3] 卢亦成[3] 

机构地区：[1]上海长征医院神经科,上海200003 [2]上海长征医院骨科,上海200003 [3]上海长征医院神经外科,上海200003

出　　处：《临床神经电生理学杂志》2004年第4期200-203,共4页Journal of Clinical Electroneurophysiology

摘　　要：目的 :探讨脊髓体感诱发电位 (SEP)与运动诱发电位 (MEP)在脊髓手术中联合监测的临床应用价值。方法 :对 18例脊柱手术患者进行术中SEP和MEP联合监测 ,并用日本矫形学会量表 (JOA)对患者术后神经功能进行评价。结果 :全部患者术中SEP的P1、N1波幅有暂时性波动 ,潜伏期无明显变化。 10例患者MEP的D1波波幅降低 ,但经改变手术方向后恢复正常 ,另 8例患者MEP无明显变化。术后JOA评分较术前明显改善。结论 :SEP及MEP术中联合监测 ,其波形稳定可靠 ,有利于避免“假阴性 /假阳性”结果及术后神经功能障碍的发生。Objective:To explore the clinical application of monitoring by combination of spinal somatosensory evoked potentials (SEP) and motor evoked potentials (MEP) during operation for patients with spinal cord or vertebral column disorders. Methods:Eighteen patients with spinal cord or vertebral column disorders were monitored by the combination of SEP and MEP. Japanese Orthorpaedic Association Score (JOAS) was adopted to evaluate the patients’ clinical nervi function.Results:Slight fluctuation of the amplitude of both N1 and P1 of SEP appeared transiently in 18 patients during the operation and the latencies of SEPs were consistent with the first recordings. Both the amplitude and latencies of D1 of spinal MEPs recorded at operation were the same as those recorded after the operation in 8 patients receiving orthopaedic operation. The amplitude of D1 of MEPs decreased in 10 patients with spinal disorders but resumed to normal after a brief rest and changing the operative direction. JOA scores improved significantly after operation than those before operation. Conclusion:The waveform of either SEPs or MEPs might be stable and reliable in monitoring patients during operation. It might be helpful in avoiding “false negative and/or false positive results” as well as the postoperative nervi dysfunction.

关 键 词：脊髓 体感诱发电位 运动诱发电位 术中监测 

分 类 号：R651.2[医药卫生—外科学]