BAEP和EMG在后颅凹手术监护中的应用  

Application of intraoparotive monitoring with brainstem auditory evoked potential and .eleetromyogram in posterior fossa surgery

作　　者：朱沂[1] 杨小朋[2] 李建新[1] 李静[1] 郑勇[2] 吴红星[2] 张振宇[2] 阿里木[2] 

机构地区：[1]新疆维吾尔自治区人民医院神经内科,新疆乌鲁木齐830001 [2]新疆维吾尔自治区人民医院神经外科,新疆乌鲁木齐830001

出　　处：《癫痫与神经电生理学杂志》2010年第1期30-33,共4页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：评价脑干听觉诱发电位（BAEP）和面肌肌电图（EMG）对后颅凹手术监护的价值。方法：对44例后颅凹病变的患者进行术中BAEP和面肌EMG的监护，观察其对脑干、面神经功能和有效听力的保护结果。结果：术中BAEP报警10例（23％），均发生在微血管减压组、听神经瘤组和脑干肿瘤组。脑干功能异常3例（7％），死亡1例（2％），各组间差异无显著意义。1年后随访，听神经瘤组面神经功能保留18例（82％），2例术前具有有效听力的患者术后听力均得以保留，1例重度听力障碍的患者术后恢复有效听力。结论：BAEP对微血管减压、听神经瘤和脑干肿瘤手术的脑干功能监护价值较大，对听力保护意义较小；EMG显著提高面神经功能保留率，但需要加强手术医生与监护者之间的协作。Objective： To explore the value of Brainstem auditory evoked potential （BAEP） and electromyogram （EMG） of intraoperative monitoring in the operation of fossa cranii posterior diseases. Methods： Posterior fossa surgeris on 44 patients were intraoperatively monitored with BAEP and EMG of facial muscles,and brainstem function, facial paralysis and useful hearing were evaluated after operation. Results： The warning rate of BAEP was 23% （10 cases）,only in the groups of microvaseular decompression, brainstem tumor and acoustic neurinoma. Brainstem function of 3 cases（7%） were damaged and 1 died（2%）, No difference was found in those groups. After 1 year＇s follow-up, the functional reservation of facial nerves was 82 % （18 cases） of acoustic neurinoma, the useful hearing was preserved in 2 patients and the other one improved. Conclusion： BAEP intraoperative monitoring is the valid and reliable tool to protect brainstem in posterior fossa surgery especially of microvascular decompression , brainstem tumor and acoustic neurinoma,but＇not to hearing protection, It is important to emphasize the cooperation between the surgeons and monitors to protect facial nerves.

关 键 词：后颅凹 术中监测 脑干听觉诱发电位(BAEP) 肌电图(EMG) 

分 类 号：R651.11[医药卫生—外科学] R741.044[医药卫生—临床医学]