脊柱手术中体感诱发电位监护  

Application of Cortical Somatosensory Evoked Potential Monitoring in Spinal Surgery

作　　者：陈波[1] 阮狄克[1] 侯黎升[1] 

机构地区：[1]海军总医院骨科,北京100037

出　　处：《中国矫形外科杂志》2002年第3期216-218,共3页Orthopedic Journal of China

摘　　要：目的 :研究体感诱发电位监护脊柱手术的监测技术。方法 :采用皮层体感诱发电位 (CSEP)监测 90例手术 ,记录每个重要手术步骤前、中、后CSEP ,观察其改变并分析原因。结果 :麻醉深度与麻药种类对CSEP有影响 ,其中以异氟醚为明显。脊柱手术中的操作均可引起CSEP改变。 1例CSEP波形离散持续 5min的患者术后出现可逆性脊髓损伤。结论 :CSEP有简便、灵敏和及时监护等特点 ,波幅下降 5 0 % ,潜伏期延长 10 %是术中监护的预警值 ,对同时出现波形离散Objective: To study the technique application of cortical somatosensory evoked potential(SEP) monitoring in order to preventing intraoperative neurological complication.Methods:90 cases with spinal abnormality underwent surgical management monitored by CSEP.every important surgical step was monitored by observing and comparing the changes of amplitude and latency of CSEP.Result:Anesthetic agents could affect CSEP, surgical processes including hooking,rod distraction and compression also affect the amplitude and latency of CSEP,one patient who had abnormal types of CSEP during operation for 5 minutes had partial dysfunction of spinal cord post operative temporarily.Conclusion:CSEP is an ideal monitoring method in spinal surgery,amplitude decreases by 50% and latency prolong by 10% will alarm for risk of damage to the spinal cord,meanwhile,alarm situation combine with abnormal type CSEP for more than two minutes is a high risk of neurologic impairment.

关 键 词：皮层体感诱发 术中监护 术前检查 

分 类 号：R681.5[医药卫生—骨科学]