吲哚菁绿荧光造影和经颅电刺激运动诱发电位联合监测在前循环动脉瘤夹闭术中的应用  

The application research of indocyanine green fluorescein angiography and transcranial electrical stimulation motor evoked potential combination monitoring in anterior circulation aneurysm clipping operation

作　　者：余舰[1] 张扬 晁迎九[1] 魏建军[1] 牛朝诗[1] 傅先明[1] 高歌[1] 陈昱[1] 顾大群[1] 

机构地区：[1]安徽省立医院神经外科,安徽省脑立体定向神经外科研究所,合肥230001

出　　处：《立体定向和功能性神经外科杂志》2014年第5期277-280,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的探讨术中吲哚菁绿荧光造影(ICGA)和经颅电刺激运动诱发电位(TES-MEP)联合监测在前循环动脉瘤夹闭手术中的应用价值。方法回顾性分析2013年6月至2014年3月收治的58例前循环动脉瘤夹闭患者的临床资料。其中ICGA和MEP联合监测组(ICGA+MEP组)37例,无监测组(非ICGA+MEP组)21例,手术均采取翼点入路动脉瘤夹闭术。比较两组患者术后预后情况及脑缺血发生率,并观察ICGA和MEP对术中策略的影响。结果按照GOS评价预后,ICGA+MEP组术后GOS分级明显高于非ICGA+MEP组,术后脑缺血发生率明显低于后者;同时ICGA和MEP联合监测对部分患者术中策略调整起着积极的作用。结论 ICGA和MEP联合监测可术中实时调整手术策略,有效降低手术并发症和提高患者术后生活质量,并能相互补充。Objective To investigate the value of combined monitoring of indocyanine green angiography（ICGA）and transcranial electrical stimulation motor evoked potentials（TESMEP）on anterior circulation aneurysm clipping operation.Methods The clinical data of 58 patients of anterior circulation aneurysms from 2013 June to 2014 March were analyzed retrospectively.The combined monitoring of ICGA and MEP（ICGA＋MEP group）37cases,non monitoring（non ICGA＋MEP group）21cases,operation adopt pterional approach aneurysm clipping.The two groups of patients with postoperative prognosis and the incidence of cerebral ischemia were compared,and observe the effects of ICGA and MEP on intraoperative strategies.ResultsAccording to GOS evaluation of prognosis,ICGA＋MEP group was significantly higher than non ICGA＋MEP group,and postoperative cerebral ischemia was significantly lower than latter.And the use of ICGA and MEP during surgery presented positive impact on the adjustment of operative strategy in some cases.Conclusion The ICGA and MEP combined monitoring can real-time adjust operation strategy in.

关 键 词：前循环动脉瘤 荧光造影 运动诱发电位 术中监测 

分 类 号：R739.41[医药卫生—肿瘤] R651.12[医药卫生—临床医学]