电刺激运动诱发电位监护在脊柱脊髓手术中的应用  

Application of motor-evoked potential monitoring with transcranial electrical stimulation in spinal operations

作　　者：李郑林 柳晓秋[2] 于博[3] 

机构地区：[1]深圳市平乐骨伤科医院老年骨科,518010 [2]南方医科大学珠江医院神经外科,广州510282 [3]南方医科大学珠江医院骨科,广州510282

出　　处：《中华神经医学杂志》2007年第9期935-939,共5页Chinese Journal of Neuromedicine

摘　　要：目的观察运动诱发电位在脊柱脊髓手术监护中的应用效果。方法对30例脊柱脊髓手术患者采用经颅电刺激—四肢肌记录肌活动电位,行术中脊髓机能监测,其中对采用经颅电刺激—四肢肌记录无效者,配合经脊髓硬膜外刺激—四肢肌记录肌活动电位。结果30例采用经颅电刺激—四肢肌记录方法,其中26例于术中和术后都记录到了正常的运动诱发电位波形。其余4例改为使用经脊髓硬膜外刺激—四肢肌记录方法后,共29例患者的运动诱发电位获得记录。结论采用经颅电刺激,并配合经脊髓硬膜外刺激—四肢肌记录肌活动电位,使术中对脊髓内部运动传导通路机能监测的有效率得到了提高。Objective To observe the effectiveness of motor-evoked potentials （MEPs） monitoring with transcranial electrical stimulation （TES） in spinal operations. Methods MEPs recorded from four limb muscles following TES （TES-MEPs） were used in 30 patients undergoing spinal operations to execute intraoperative monitoring of spinal cord function, and MEPs recorded from four limb muscles following epidural spinal cord stimulation （Spinal-MEPs） were applied conjunctively for those with ineffective TES-four limb muscle recordings. Results Normal TES-MEPs waveforms were recorded intraoperatively from 26 of the 30 cases and Spinal-MEPs were recorded in the other four cases who did not respond to TES-MEPs. TES-MEPs and Spinal-UEPs were recorded in 29 of the 30 cases. Conclusion TES-MEPs applied in combination with Spinal-MEPs, intraoperative monitoring of motor tract function of the spinal cord can be achieved more effectively.

关 键 词：运动诱发电位 术中监护 运动机能 脊柱脊髓手术 

分 类 号：R651.2[医药卫生—外科学] R687[医药卫生—临床医学]