运动诱发电位联合体感诱发电位监测在脊髓髓内肿瘤手术中的应用  

Application of combined monitoring of motor evoked potentials and somatosensory evoked potentials during intramedullary spinal cord tumor operation

作　　者：陶晓蓉[1] 乔慧[1] 李群喜[1] 王明然[1] 刘莉[1] 杨丽蕊[1] 

机构地区：[1]首都医科大学北京市神经外科研究所,100050

出　　处：《中华神经外科杂志》2010年第12期1086-1089,共4页Chinese Journal of Neurosurgery

摘　　要：目的 探讨全静脉麻醉下运动诱发电位（MEP）联合体感诱发电位（SEP）术中监测应用于脊髓髓内肿瘤手术的优越性、可靠性及临床应用价值.方法 对72例脊髓髓内肿瘤患者术中行SEP和MEP联合监测,参照McCormick评分标准对术前、术后脊髓功能的改变和诱发电位变化之间的关系进行统计分析.结果 14例脊髓神经功能改善,18例术后脊髓神经功能下降者与诱发电位监测结果具有一致性（P＜0.05）.结论 对脊髓髓内肿瘤手术进行SEP与MEP监测有利于避免＂假阴性/假阳性＂结果及术后神经功能障碍的发生.Objective To investigate the reliability,superiority and value of combined monitoring of motor evoked potentials（MEP） and somatosensory evoked potentials（SEP） during intramedullary spinal cord tumor surgery under total intravenous anesthesia.Method 72 patients with intramedullary spinal cord tumor were monitored somatosensory evoked potentials and muscle motor evoked potentials during operation.McCormick scale was adopted to evaluate the patients＇ clinical nerve function.The postoperative to preoperative McCormick grade variation and combimed monitoring of SEP and MEP were compared in this group.Result 14 patients＇ nerve function was improved.The findings of monitoring were evaluated in 18 patients with depressed McCormick scores.There was significant difference in the latency and amplitude of waves between pretreatment and post-treatment （P〈0.05）.The changes of SEP and MEP were correlative with the changes of spinal cord function.Conclusion Combined monitoring of SEP and MEP could help to improve postoperative McCormick scale outcome significantly for patients with intramedullary spinal cord tumor.The waveform of either SEP or MEP might be stable and reliabie in monitoring patients under total intravenous anesthesia.It might be helpful in avoiding ＇false negative and/or false positive results＇as well as the postoperative neurological sequelae.

关 键 词：脊髓 体感诱发电位 运动诱发电位 

分 类 号：R686[医药卫生—骨科学]