赛机宁对脑瘫患儿脊神经根诱发肌电图监测的影响  

Effect of Nimbexonevoked Electromyography Monitoring of Spinal Nerve Rootin children with Cerebral Palsy

作　　者：刘建波 赵泽宇 张蓉 王馨雪 黄建盛 程庆 

机构地区：[1]四川省八一康复中心麻醉科,四川成都611135

出　　处：《四川医学》2014年第9期1118-1120,共3页Sichuan Medical Journal

基　　金：四川省卫生厅科研课题(编号:130250)

摘　　要：目的 探讨赛机宁不同外周神经肌肉阻滞程度（NMB）对脑瘫患儿脊神经根诱发肌电图监测的影响。方法择期拟行功能性选择性腰部脊神经后根切断术的脑瘫患儿20例,ASAⅠ或Ⅱ级,年龄3-12岁,性别不限。麻醉诱导后,使用Nicolet Endeavor-CR16通道的电生理监护仪,对拟切除的脊神经后根连续3次电刺激,间隔时间为5s,刺激强度为3.50mA,记录所刺激的神经根诱发相应肌群肌电图（EEMG）的平均振幅和潜伏期作为基础值。静脉推注赛机宁0.05mg/kg,当外周神经肌肉阻滞程度分别为100%、75%、50%、25%时再次以同样的强度刺激及间隔时间连续进行3次电刺激,记录EEMG的平均振幅和潜伏期。观察振幅保留比率和潜伏期的变化与赛机宁不同NMB程度之间的关系。结果随着NMB减少,振幅保留比率逐渐增大,振幅保留比率（Y）与NMB（X）呈负相关关系,相关系数R为0.960a（P〈0.01）。NMB在50%-100%时,潜伏期较基础值明显延长,潜伏期（Y）与NMB（X）呈正相关关系,相关系数R为0.481a（P〈0.01）。结论 赛机宁可影响脊神经根诱发肌电图监测,随着NMB程度逐渐降低,振幅保留比率逐渐增大,潜伏期缩短。Objective To investigate the effect of nimbex different peripheral neuromuscular blockade（ NMB） on evoked electromyography monitoring（ EEMG） of spinal nerve root in children with cerebral palsy. Methods Twenty ASA physical statusⅠorⅡchildren with cerebral palsy of both sexes, aged 3-12 yr, scheduled for elective functional selectivity of lumbar posterior rhizotomy, were included in the study. After induction of anesthesia, the spinal nerve root was accepted continuous electrical stimulation for 3 times with the electrophysiological monitoring of Nicolet Endeavor-CR 16 channel, interval 5s, the stimulus intensity of 3. 50 mA. The average amplitude and latency ofEEMGwere recorded as basic values. Intravenously injection nimbex 0. 05mg/kg,then the spinal nerve root was accepted continuous electrical stimulation for 3 times as the same intensity of stimulation and the interval time when NMB were 100%, 75%, 50%, 25%. The average amplitude and latency were recorded respectively,then analyzed the relationship betweenamplitude retention ratio andlatency with nimbex different NMB. Results With the decrease of NMB, the amplitude retention ratio was increases, the amplitude retention ratio （ Y） and NMB （ X） showed negative correlation, the correlation coefficient R was 0. 960 ^a（P〈0. 01）. When NMB was 50% - 100%, the latency was significantly prolonged than basic values, the latency（ Y） and NMB（ X） is positive correlation, the correlation coefficient R was 0. 481 ^a （ P〈 0. 01 ） . Conclusion The nimbex would affect the spinal nerve root EEMG. With the degree of NMB gradually decreased, the amplitude retention ratio was increases and the latency was shortening gradually.

关 键 词：赛机宁 N2胆碱受体阻断药 肌电图 术中监测 脊神经根 脑性瘫痪 儿童 

分 类 号：R742.3[医药卫生—神经病学与精神病学]