腰椎术中高频电刀对皮节体感诱发电位的影响  

Influence of hypercator for evaluate dermatomal somatosensory evoked potentials in lumbar spine operating

作　　者：高维涛[1,2] 李放[2] 章建平[2] 

机构地区：[1]中国人民解放军总医院、军医进修学院,北京100853 [2]北京军区总医院骨科

出　　处：《癫痫与神经电生理学杂志》2012年第4期227-229,共3页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：通过观察腰椎术中L5神经根减压后高频电刀使用后不同时间短潜伏期皮节体感诱发电位（DSEP）P40波潜伏期和波幅的变化，探讨高频电刀对皮节体感诱发电位（DSEP）的影响。方法：对36例单侧L5神经根压迫接受开窗手术患者，在术中进行受累神经根DSEP监测，观察并记录减压后使用高频电刀不同时间节点（使用前，电刀停止即刻、停止后5min及10min）的P40波潜伏期、波幅的数据，通过对照评价术中高频电刀对DSEP监测的影响。结果：与减压后（使用电刀前）相比，电刀停止后即时P40波潜伏期明显延长、波幅明显下降（P＜0．05）；停止后5min时P40波潜伏期、波幅无明显恢复（P＜0．05）；10min时，潜伏期和波幅变化无显著差异（P＞0．05）。结论：在术中高频电刀的使用将影响DSEP的监测结果，应在电刀停止10min后记录波形才准确。Objective：To discuss the influence of hypercator on dermatomal somatosensory evoked potentials（DSEP） by observing the changes of P40 latency and amplitude after lumbosacral nerve root decompression in operating. Methods：Thirty-six cases with unilateral L5 nerve root oppression were monitored by DSEP in fenestrative operation. P40 latency and amplitude data at different time after use of hypercator（before hemostasis, and after hemostasis/time= 0 min, 5 min and 10 rain） were recorded and observed. Then the influence of hypereator on DSEP was evaluated. Results： P40 latency significantly prolonged and the amplitude ovbiously declined when the operation by hypereater（P〈0.05）. Both of them had no obvious changes 10 rain later（P〉0. 05）. Conclusion..DSEP should be monitored 10 min after the operation by hypercater for the use of hypercator will influence DSEP in operation.

关 键 词：腰椎 手术 高频电刀 皮节体感诱发电位(DSEP) 影响 

分 类 号：R681.53[医药卫生—骨科学] R741.044[医药卫生—外科学]