电生理监测下显微手术切除胸段脊髓腹侧脊膜瘤  

Clinical value of intraoperative electrophysiological monitoring in microsurgical resection of ventral thoracic meningiomas

作　　者：林国中[1] 王振宇[1] 赵薇[1] 

机构地区：[1]北京大学第三医院神经外科,北京100191

出　　处：《中国临床神经外科杂志》2013年第12期728-730,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨在电生理监测下显微手术切除胸椎腹侧脊膜瘤的效果。方法回顾性分析2009年12月至2012年12月收治的68例胸段脊髓腹侧脊膜瘤患者临床资料。采用后正中入路手术切除肿瘤,所有手术均在电生理监测下进行。结果肿瘤全切62例(91.2%),大部分切除6例(8.8%)。术后1周神经功能障碍改善46例,无变化10例,加重8例。术后64例(94.2%)随访4个月～2年,神经功能均较术前改善,其中完全正常者55例;无肿瘤复发。结论采用显微手术切除胸段脊段腹侧脊膜瘤是治疗该病有效的方法,术中电生理监测有助于手术的安全进行。Objective To explore the clinical value of intraoperative electrophysiological monitoring in microsurgical resection of ventral thoracic meningiomas. Methods Sixty-eight patients with ventral thoracic meningioma received microsurgery through posterior midline approach from December 2009 to December 2012 in our hospital. All procedures were performed under the intraoperative eleetrophysiologic monitoring using somatosensory evoked potentials （SEP）, motor evoked potentials （MEP） and electromyography （EMG）. Results Abnormal SEP or MEP occurred in 41 patients, of whom, 39 recovered after treatment; abnormal EMG occurred in 5 and all recovered after treatment. Total resection was achieved in 62 patients （91.2%） and subtotal in 6 （8.8%）. Neurologic function improved in 46 patients （67.6%）, did not change in 10 （14.7%） and worsened in 8 （11.8%） after operation. Sixty-four patients were followed up for 4N24 months; no patient recurred; the neurologic function recovered in 55 patients （85.9%） and improved in 9 patients （14.1%）. Conclusions Microsurgical resection is an effective treatment method for ventral thoracic meningiomas. Intraoperative clcctrophysiological monitoring helps to decrease surgery-related injuries and postoperative complications.

关 键 词：脊膜瘤 胸段脊髓 腹侧 显微手术 电生理监测 

分 类 号：R739.42[医药卫生—肿瘤] R616.2[医药卫生—临床医学]