体感诱发电位监护在先天性脊柱侧凸矫形术中的应用价值  

The utilization of SEP detection in the orthopaedics procedures for congenital scoliosis

作　　者：袁国莲[1] 齐华光[2] 党小谦[1] 黄亚娟[1] 

机构地区：[1]西安交通大学医学院第二附属医院骨一科,陕西西安710004 [2]西安市红十字会医院肌电图室

出　　处：《癫痫与神经电生理学杂志》2011年第4期206-209,共4页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：探讨体感诱发电位（SEP）在先天性脊柱侧凸矫形术中的应用价值。方法：对30例先天性脊柱侧凸患者在矫形术中连续进行皮层SEP监测，设定报警标准，记录术中变化，并与术后进行比较。结果：在30例患者中，14例（47％）手术全过程SEP平稳，术后未出现神经系统体征。余16例（53％）术中SEP出现异常变化：7例为麻醉后有波出现但不稳定，9例在手术操作中出现报警．其中8例经暂停手术操作，查找原因，待波形恢复后继续完成手术，术后未出现新的神经系统体征；1例术中虽有报警，但未采取措施，直至手术结束时波形仍未恢复，术后患者出现新的神经系统阳性体征。结论：脊柱侧凸矫形术中SEP的变化较大。应用SEP进行术中监测。同时合理设定基准值及报警值．能最大限度地降低因手术造成的脊髓损伤发生率。Objective：To investigate the value of somatosensory cvoked potential （SEP） in the or thopaedics procedures for congenital scoliosis. Methods： 30 cases with congenital scoliosis underwent cor rective operation monitored by cortical SEP,and with alarm standards, the changes in-operation were re corded, and post-operative changes were compared. Results：In 14 cases SEP was smooth and stable dur ing the whole process and no change in neurological symptoms was found. In other 16 cases SEP was ab normal including unstable waves after anesthesia in 7 cases, alarm signals in 9 eases in which 8 cases re tarned to operation after the reasons was found and the waveform kept normal and no was found and neurological symptoms occurred; But in one case, the ware form was abnormal new neurological symptoms appeared afleration. Conclusion： SEP is an ideatmethod to monitor the spinal cord function in scoliosis surgery.

关 键 词：体感诱发电位(SEP) 脊柱侧凸矫形术 术中监护 

分 类 号：R741.044[医药卫生—神经病学与精神病学] R682.3[医药卫生—临床医学]