部分肌松下肌电图监测在面肌痉挛微血管减压术中的意义  

Electromyogram Monitoring of Partial Muscle Relaxant During Microvascular Decompression for Hemifacial Spasm

作　　者：徐晓红[1] 杨程[1] 崔苏扬[1] 

机构地区：[1]江苏省南京中医药大学附属医院麻醉科,江苏南京210029

出　　处：《医学临床研究》2010年第1期97-98,共2页Journal of Clinical Research

摘　　要：【目的】探讨部分肌松[神经肌肉阻滞（NMB）=50％]下面肌异常肌电图监测在微血管减压术中的安全性和指导意义。【方法120例面肌痉挛患者面肌诱发肌电图监测下行微血管减压术，术中保持NMB=50％。开颅前将刺激电极刺入患侧口轮匝肌记录诱发肌电图，分别在硬脑膜切开后、排放脑脊液、剥离压迫血管、垫入泰氟隆后、缝合硬脑膜完毕记录诱发面肌肌电图。【结果】19例于术前记录到潜伏期约10ms的异常诱发肌电图波形，术后18例异常诱发肌电图波形消失，手术治愈率90％。【结论】部分肌松可安全应用于诱发肌电图监测，术中面肌异常肌电图监测对指导和判断责任血管和减压效果有实用价值。[Objective] To explore the importance and safety of intraoperative aberrant response monitoring with partial muscle relaxant （NMB= 50 %） as a guide for mierovascular decompression. [Methods]Forty patients of hemifacial spasm underwent intraoperative monitoring of facial aberrant responses during microvascular decompression. Muscle relaxant was controlled with TOF monitor in the study （NMB=50%）. The aberrant responses were recorded from the orbicularis oris muscle during stimulation of the temporal branch of the facial nerve. [Results] Before opening the dura mater, 19 of 20 cases showed aberrant responses width a latency of about 10 ms after stimulation. These responses disappeared in 18 patients at the end of operation. The complete recovery rate was 90 %. [Conclusion] Partial muscle relaxant is safe in operative facial nerve monitoring. Facial aberrant response recordings are useful to identify the compressing vessel that causes the spasm and to ensure that complete decompression of the nerve is accomplished.

关 键 词：肌痉挛/外科学 面部肌肉 血管外科手术 肌电描记术 

分 类 号：R746.9[医药卫生—神经病学与精神病学]