脑干听觉诱发电位的Ⅴ波PL延长在听神经瘤手术监护中的应用价值  

Peak latency prolongation of Ⅴ wave in brainstem auditory evoked potential during intraoperative monitoring of acoustic neuroma surgery

作　　者：包国庆[1] 朱沂[1] 李建新[1] 杨小朋[1] 

机构地区：[1]新疆维吾尔自治区人民医院神经内科,乌鲁木齐830001

出　　处：《中华神经医学杂志》2012年第1期65-67,共3页Chinese Journal of Neuromedicine

摘　　要：目的 探讨BAEP的Ⅴ波PL延长在听神经瘤手术中的应用价值. 方法 回顾性分析55例听神经瘤手术患者行BAEP术前检查、术中监护及术后疗效评估,分析Ⅴ波PL延长不同指标的监测结果. 结果 以Ⅴ波PL延长＞0.6 ms为标准,脑干或听神经损伤的灵敏度100％,特异度95.3％,误诊率4.7％,漏诊率0％,符合率96.4％.以Ⅴ波PL延长＞1.0 ms为标准,灵敏度58.3％,特异度97.7％,误诊率2.3％,漏诊率41.7％,符合率89.1％. 结论 BAEP监护听神经瘤手术中,V波PL延长＞0.6 ms有较高的敏感度和特异度,作为术中监护报警指标更合适.Objective To explore the applied value of peak latency （PL） prolongation of Ⅴ wave in brainstem auditory evoked potential （BAEP） during intraoperative monitoring of acoustic neuroma surgery. Methods The preoperative BAEP examination data,intraoperative monitoring and postoperative evaluation data in 55 patients with acoustic neuroma were retrospectively analyzed; the monitoring results under the circumstance that different degrees of prolongation of PL of Ⅴ wave were chosen were analyzed. Results The PL prolongation of Ⅴ wave 〉0.6 ms was used as the baseline,the sensitivity of diagnosing the brainstem or acoustic nerve injury was 100%,the specificity was 95.3%,the misdiagnosis rate was 4.7%,the missed diagnosis rate was 0% and the accordance rate was 96.4%.The PL prolongation of Ⅴ wave 〉1.0 ms was used as the baseline,the sensitivity of diagnosing the brainstem or acoustic nerve injury was 58.3%,the specificity was 97.7%,the misdiagnosis rate was 2.3%,the missed diagnosis rate was 41.7% and the accordance rate was 89.1%. Conclusion It is more suitable that using thePL prolongation of Ⅴ wave 〉0.6 ms as the baseline,enjoying high sensitivity and specificity,during the intraoperative monitoring of acoustic neuroma.

关 键 词：脑干听觉诱发电位 听神经瘤 术中监护 

分 类 号：R739.41[医药卫生—肿瘤]