神经电生理监测和唤醒试验在脊柱手术中的保护作用及比较——多中心大样本量研究  

Comparison of Protective Effects of Neurophysiology Monitoring and Wake-up Test in Spinal Surgery:Multi-center and Large Sample Size Trial

作　　者：陈奇[1] 李锋[1] 张勇[1] 沈凯[1] 陈安民[1] 郭风劲[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院骨科,武汉430030

出　　处：《华中科技大学学报（医学版）》2010年第6期833-835,共3页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家"十一五"科技支撑计划资助项目(No.2007BAI04BO7)

摘　　要：目的探索神经电生理监测和唤醒试验在脊柱手术中的保护作用并比较它们的效果。方法全国4所大型医疗机构提供符合准入标准的病例,以配比法排除混杂因素,用χ2检验比较它们在脊柱类手术中对脊髓、神经的术中保护作用,以P<0.05为差异具有统计学意义。结果对于L1以上节段的脊柱手术,这两种方法均能减少神经症状的加重,但两者之间无明显差异。结论神经电生理监测和唤醒试验都能很好地减少30岁以下人群的颈、胸、胸腰段脊柱手术脊髓、神经损伤的发生率,虽然单纯从效果看,神经电生理监测并不比唤醒试验更有优势,但是由于它克服了唤醒试验的很多缺点,仍然值得在临床大力推广。Objective To investigate the protective effects of wake-up test and neurophysiology monitoring in spinal surgery.Methods Extracted data from four large medical institutions participated in this study were organized,entered into a database,and compared statistically with χ2 test.Confounders were eliminated with matching method.Significance was accepted for P0.05.Results Either neurophysiology monitoring or wake-up test decreased the incidence of spinal cord and nerve injury in spinal surgery above L1,however,no significant differences were found between these two methods.Conclusion Wake-up test and neurophysiology monitoring can significantly decrease the incidence of spinal cord and nerve injury in cervical,thoracic and thoracolumbar surgeries.Neurophysiology monitoring seems have no more advantages in protective effects over wake-up test,however,it＇s also worth to be promoted in clinic,because this method has settled many other problems caused by wake-up test.

关 键 词：神经电生理监测 唤醒试验 脊柱手术 保护作用 

分 类 号：R681.5[医药卫生—骨科学]