电生理监测技术联合解剖定位在脑运动区手术中的应用  

The application of intraoperative electrophysiological technology and stereotactic anatomy in brain motor area lesions

作　　者：邓大丽[1] 牛朝诗[2] 喻廉[1] 熊赤[2] 

机构地区：[1]安徽省立医院安徽省脑立体定向神经外科研究所,合肥230001 [2]安徽省立医院神经外科脑功能与脑疾病安徽省重点实验室

出　　处：《中华解剖与临床杂志》2015年第2期174-177,共4页Chinese Journal of Anatomy and Clinics

基　　金：安徽省科技攻关项目（11010402165）;安徽省重点实验室绩效考核项目（1306c083028）

摘　　要：目的探讨电生理监测技术联合解剖定位在脑运动区手术中的应用。方法在Pubmed和中国知网数据库，以电生理监测技术、解剖定位和脑运动区手术为关键词，查阅1997年5月—2013年12月关于电生理监测技术与脑运动区解剖定位在脑运动区手术中应用的相关文献，进行分析总结。结果解剖定位包括功能MR和影像导航。电生理监测脑功能定位技术包括体感诱发电位位相倒置技术、经颅电刺激运动诱发电位、皮层电刺激运动区定位、皮层电刺激语言区定位、皮质下电刺激定位运动通路。解剖定位和电生理监测技术在脑运动区手术中各有利弊，目前趋势是联合应用。结论在脑运动区手术中，应用电生理监测联合解剖定位可提高脑运动区解剖定位的精确度，达到最大限度切除肿瘤、保留神经功能的作用。Objective To explore the application of electrophysiological monitoring in anatomical location of cerebral motor area. Methods The literatures from May 1997 to December 2013 in Pubmed and National Knowledge Infrastructure database were searched by using keywords electrophysiological monitoring technology, anatomical localization and cerebral motor area surgery, and the electrophysiological monitoring associated with anatomical orientation of cerebral motor areas was summarized. Results Anatomical landmarks included functional magnetic resonance images and navigation. It employed various methods such as intraoperative somatosensory and motor evoked potentials monitoring, intraoperative cortical and sub-cortical stimulation, awaking anesthesia and the comprehensive exploitation of neuronavigation. Stereotactic anatomy and electrophysiological technology had its advantages and disadvantages. At present, combination use of the two methods is the trend of clinical application. Conclusions In cerebral motor areas, combined of stereotactic anatomy and electrophysiological technology can improve the accuracy of anatomical location. The combined application of two methods can achieve the effects of maximum degree of resection of the tumor and maximize the retention of neural function.

关 键 词：诱发电位 运动皮质 神经导航 电生理监测 

分 类 号：R651.1[医药卫生—外科学]