颅内动脉瘤术中诱发电位监测的初步探讨  

Preliminary research on evoked potential monitoring during intracranial aneurysm surgery

作　　者：贡志刚[1] 吕丙波[2] 蒋佩龙[2] 葛玉元[2] 张荣俊[1] 

机构地区：[1]南京中医药大学苏州附属医院神经外科,苏州215003 [2]苏州大学附属第二医院神经外科

出　　处：《中华神经外科杂志》2011年第8期795-797,共3页Chinese Journal of Neurosurgery

基　　金：江苏省社会发展计划（BS2005023）志谢：感谢首都医科大学附属北京天坛医院电生理室乔慧、刘淑玲老师给予的技术指导.

摘　　要：目的初步探讨颅内动脉瘤手术中躯体感觉诱发电位、脑干听觉诱发电位及运动诱发电位的临床应用价值。方法在16例动脉瘤手术中开展诱发电位监测，观察术中电生理信号改变与术后神经功能状态的关系。结果11例术中未出现电生理信号异常改变，5例术中出现了异常信号，其中信号未能恢复正常的4例术后均出现新发神经功能障碍。结论诱发电位监测可实时了解颅内动脉瘤手术中有无脑缺血所致的神经功能障碍，对指导手术及评估预后均有重要意义。Objective To explore the application of intraoperative neuroelectrophysiological monitoring on somatosensory evoked potentials （SEP）, brainstem auditory evoked potentials （BAEP） and motor evoked potentials （MEP） during intracranial aneurysm surgery. Methods SEP, BAEP or MEPs were monitored during operations on 16 patients with intracranial aneurysms. The relationship between the intraoperative changes of e!ectrophysiological signals and the postoperative outcomes of neurological deficits was evaluated. Results 11 patients without abnormal intraoperative electrophysiological signal changes demonstrated no new neurological deficits after surgery. However, in the left 5 patients, abnormal changes of intraoperative electrophysiological signals were detected. Among these 5 patients, 4 with abnormal electrophysiological signals which were not recovered intraoperatively demonstrated new developed functional deficits immediately after surgery. Conclusion During intracranial aneurysm surgery, the monitoring on SEP, MEP and BAEP is beneficial not only to timely detecting neurological functional deficits resulted from intraoperative cerebral ischemia, but also to properly guiding surgical manipulation, and to reliably predicting postoperative outcome as well.

关 键 词：颅内动脉瘤 诱发电位 监测 显微外科手术 

分 类 号：R651.1[医药卫生—外科学]