体感诱发电位在脊柱手术中的监测作用  

The effect of somatosensory evoked potential in spinal cord monitoring during operation

作　　者：齐宗华[1] 王德春[1] 季爱玉[1] 胡有谷[1] 

机构地区：[1]青岛大学医学院附属医院骨科山东省创伤骨科研究所,青岛市266003

出　　处：《中国脊柱脊髓杂志》2005年第5期278-280,共3页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:探讨脊柱外科手术中体感诱发电位监护技术的准确性。方法:对78例颈、胸椎手术患者术中采用皮层体感诱发电位(cortical som atosensory evoked potential,CSEP)术中监测,记录术前、术中、术后各个重要手术步骤的CSEP变化,根据不同阶段诱发电位的变化与术后临床脊髓功能改变相结合,判断CSEP的准确性。结果:78例患者中,CSEP未达到监护界值71例,术后无脊髓损伤;5例患者术中CSEP达到预警标准,告诫手术医生,注意手术操作,术后无脊髓损伤;另外,出现假阳性和假阴性各1例,术后恢复亦良好。结论:排除各种干扰因素后体感诱发电位可较准确地对脊髓的功能状况进行监测,是较准确的脊柱外科手术监护技术。Objective:To study how to increase the accuracy of somatosensory evoked potential in spinal cord monitoring during spinal surgery.Method:The cortical somatosensory evoked potential(CSEP) were used to monitor the spinal cord function during surgery and the CSEP were also recorded before and after surgery so that the accuracy of CSEP can be judged by comparison.Result:In 78 cases,71 cases did not reach the warning standards;5 cases reached the warning standards during surgery and the surgeons were warned to take accurate steps to finish the operations;one case was false positive and another was false negative,there were no spinal cord deterioration after surgery.Conclusion:With the cooperation of electrical physician,anesthetist and surgeon,the somatosensory evoked potential can reflect the physiological and pathophysiologiacl conditions of spinal cord after ruling out the interfering factors.

关 键 词：皮层体感诱发电位 脊髓监护 

分 类 号：R683.2[医药卫生—骨科学] R741.044[医药卫生—外科学]