体感诱发电位在主动脉外科的应用  

Application of somatosensory evoked potentials in aortic surgery

作　　者：段玉印[1] 董秀华[2] 郑军[3] 潘旭东[3] 朱俊明[3] 刘永民[3] 齐瑞东[3] 刁力为[3] 卢苇[3] 赵宏磊 孙立忠[1] 

机构地区：[1]昆明医科大学第一附属医院心外科,650032 [2]首都医科大学附属北京安贞医院麻醉科,100029 [3]首都医科大学附属北京安贞医院心外科北京市大血管疾病诊疗研究中心,100029

出　　处：《中华胸心血管外科杂志》2015年第4期201-204,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的 研究体感诱发电位（somatosensory evoked potentials,SSEP）在国人主动脉外科的应用初步效果.方法 2013年11月至2014年6月,36例主动脉疾病患者行术中SSEP监测.男22例,女14例;年龄（44.1±l3.2）岁;身高（171.2±10.1）cm;体质量（71.7±11.5） kg.主动脉夹层例27例,主动脉瘤9例.孙氏手术16例,常温全胸腹主动脉替换9例,Bentall手术5例,升主动脉替换3例,术中降主动脉支架置入术2例,胸主动脉替换1例.SSEP异常的标准为潜伏延长超过10％或波幅下降50％,监测至手术结束时,观察波形是否恢复正常,随访患者术后是否有显性神经功能缺陷.结果 SSEP波形清晰可辨30例,术中波形发生改变25例,未发生改变5例,手术结束时波形均恢复正常;6例干扰较大,无法判读.术后均无显性神经功能缺陷.结论 国人主动脉手术中可行SSEP术中监测,术中监测结果与临床一致.Objective To investigate the methods and the value of somatosensory evoked potentials （SSEP） in aortic surgery in domestic patients.Methods From November 2013 to June 2014,36 patients（22 males and 14 females） of aortic diseases in Beijing Anzhen Hospital were monitored during operation via SSEP,including 27 aortic dissection and 9 aortic aneurysm.The mean age was（44.1 ± 13.2） years.The mean high was（171.2 ± 10.1） cm.The mean weigh was（71.7 ± 11.5） kg.Surgery operations include total thoracoabdominal aortic aneurysm repair under normal thermia in 9 cases,replacement of the thoracic aorta in 1 case,replacement of the ascending aorta in 3 cases,Sun＇ s procedure in 16 cases,artificial graft implantation during open surgery in 2 cases,Bentall in 5 cases.The standard of SSEP alert was defined as a 10% change in latency or 50% change in amplitude.The terminal was if the SSEP wave restored to normal level at the end of the operation,and if the patients had neurologic deficit after operation.Results SSEP wave were clear in 30 cases,except for 6 cases that were too disturbed to be distinguished.Wave changed in 25 cases and not changed in 5 cases,but all waves restored at the end of operations.All patients have no neurologic deficit.Conclusion SSEP intraoperative monitoring in aortic surgery is available to domestic patients,and the initial study identity identify the intraoperative monitoring results were according to clinical results.

关 键 词：主动脉 体感诱发电位 术中监测 主动脉瘤 主动脉夹层 

分 类 号：R741.044[医药卫生—神经病学与精神病学]