皮层体感诱发电位监护在脊柱手术中的应用价值  

Cortical somatosensory evoked potential monitoring in spinal surgery value

作　　者：李虎年[1] 刘南平[2] 周立明[2] 孙海峰[2] 杨平[2] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏医科大学附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2010年第3期243-245,共3页Ningxia Medical Journal

基　　金：宁夏自治区卫生厅重点科研项目(W200724)

摘　　要：目的探讨脊柱手术中体感诱发电位监护技术的准确性、影响因素及临床应用价值。方法对120例脊柱手术患者术中采用皮层体感诱发电位(CSEP)监测,观察术前、术中、术后以及重要手术步骤的CSEP变化,结合术后脊髓功能改变,判断CSEP的准确性和临床价值。结果120例患者CSEP术中检测正常者112例(93.3%),术后无脊髓功能损伤;6例(5%)患者术中CSEP达到预警值标准,告诫术者注意手术操作,术后无脊髓损伤,本体感觉无异常;出现假阳性2例,术后本体感觉正常。结论排除各种干扰因素后体感诱发电位可以较准确地对脊髓功能进行监测,是具有临床应用价值的良好脊柱手术监护技术。Objective To explore the technologies accuracy, influencing factors and clinical application value of spinal somatosensory evoked potential. Methods 120 cases of spinal surgery with intraoperative cortical somatosensory evoked potential （ Cortical somatosensory evoked potential, CSEP） monitoring, observation of preoperative, intraoperative and postoperative as well as important changes in surgical procedures of the CSEP, combined with changes in spinal cord function after operation to determine CSEP accuracy and clinical value. Results In 120 cases, CSEP testing surgery in 112 （93.3%） patients without spinal cord dysfunction; 6 cases （5%） patients intraoperative CSEP to the value of the standard warning, warning surgeons to pay attention to surgical operation, surgery with non - spinal cord injury, proprioception no exception ; a false positive in 2 cases, after the normal proprioception. Conclusion The exclusion of various interference factors of somatosensory evoked potentials can be more accurate monitoring of spinal cord function, is a good clinical value of spinal surgery monitoring technology.

关 键 词：皮层体感诱发电位 脊柱 外科手术 监护 

分 类 号：R687.3[医药卫生—骨科学]