脑干功能监测在桥小脑角肿瘤手术中的临床意义  

Clinical Significance of on Brainstem Function Monitoring in Cerebellopontine Angle Tumor Surgery

作　　者：刘博虎 廉坤[1] 付国平[1] 蒲军[1] 

机构地区：[1]昆明医科大学第二附属医院神经外科,云南昆明650101

出　　处：《昆明医科大学学报》2014年第4期58-60,共3页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(30960398);昆明医科大学研究生创新基金资助项目(2013S17)

摘　　要：目的探讨桥小脑角肿瘤手术中脑干听觉诱发电位联合上肢躯体感觉诱发电位进行脑干功能监测的意义.方法 28例桥小脑角肿瘤(肿瘤直径≥3 cm)患者,均采取显微神经外科手术,术中进行神经电生理监测,主要包括脑干听觉诱发电位、双上肢躯体感觉诱发电位、自由肌电监测.术后观察脑干及颅神经功能.结果肿瘤全切23例(82%),部分切除5例(18%),脑干功能损伤1例(4%),面神经解剖保留25例(89%).结论 CPA肿瘤手术中自由肌电监测、脑干听觉诱发电位及双侧上肢躯体感觉诱发电位监测,及时为术者提供脑干功能状态,尽量避免颅神经损伤,通过对感觉上行传导通路的监测可以在一定程度上反映患侧脑干功能状态.Objective To explore the significance of monitoring the brainstem function by monitoring brainstem auditory evoked potential and somatosensory evoked potential in cerebellopontine angle tumor surgery. Methods 28 cases of cerebellopontine angle tumors （t〉 3cm） were given neurosurgery for resection of tumors, the brainstem auditory evoked potential, somatosensory evoked potential and free-run electromyogram were monitored during the surgery. Post-operative brain stem and cranial nerve function were observed. Result Tumor removal was found in 23 cases （82%）, partial resection in 5 cases （18%）, brain stem injury in 1 （4%）, facial nerve preservation in 25 cases （89%） . Conclusions Brainstem auditory evoked potential, bilateral upper extremity somatosensory evoked potential and free-run electromyogram should be recorded in the resection of cerebellopontlne angle tumors, which can provide the functional state of brain stem for the surgeon in time, to avoid cranial nerve injury. By monitoring the upstream pathway of feeling can reflect some extent state of the ipsilateral brainstem function.

关 键 词：脑干听觉诱发电位 体感诱发电位 桥小脑角肿瘤 监测 

分 类 号：R651.1[医药卫生—外科学]