诱发电位监测在前循环动脉瘤锁孔手术中的应用  

Application of evoked potential monitoring during keyhole operation of anterior circulation aneurysm

作　　者：许亮[1] 余聚[1] 王中勇[1] 陈爱林[1] 朱卿[1] 兰青[1] 

机构地区：[1]苏州大学附属第二医院神经外科,江苏省215004

出　　处：《江苏医药》2016年第10期1138-1140,共3页Jiangsu Medical Journal

摘　　要：目的探讨体感诱发电位(SEP)和经颅电刺激运动诱发电位(TES-MEP)监测在颅内前循环动脉瘤锁孔手术治疗中的应用价值。方法对78例颅内前循环动脉瘤患者在手术治疗过程中实施单纯SEP监测(A组,38例)和SEP和TES-MEP联合监测(B组,40例),分析监测诱发电位的变化对颅内动脉瘤手术的指导作用及其与术后神经功能状态的关系。结果 A组术末监测指标异常者1例,术后出现了新发神经功能障碍。术末监测指标正常者37例,有8例术后出现了新发神经功能障碍。B组术末监测指标均正常,术后2例出现新发神经功能障碍。B组术后第1天、术后2周和术后6个月预后良好病例多于A组(P<0.05)。结论诱发电位监测对颅内前循环动脉瘤的手术治疗有显著的指导意义;联合SEP与TES-MEP监测有利于降低术后缺血性脑卒中的发生。Objective To investigate the value of somatosensory evoked potential（SEP）and transcranial electrical stimulation motor evoked potential（TES-MEP）monitoring during keyhole operation for intracranial anterior circulation aneurysm.Methods Seventy-eight patients with anterior circulation aneurysms were monitored during operation with SEP（group A,38 cases）and TES-MEP（group B,40 cases）.The role of evoked potential monitoring in guiding the surgery and the association between the monitoring and postoperative neurological function status were analyzed.Results One case in group A occurred new developed functional deficits after the surgery,who was shown abnormal SEP monitored at the end of operation.The TES-MEP of all cases in group B was normal at the end of operation,of whom two cases occurred new developed functional deficits after the surgery.The cases with good prognosis on the 1^st day,in the 2^nd and 6^th weeks after operation were more in group B than those in group A（P〈0.05）.Conclusion Evoked potential monitoring has important value in guiding the surgery for intracranial aneurysm.Combined monitoring of SEP and TES-MEP during keyhole operation for intracranial anterior circulation aneurysm is helpful to reduce the occurrence of postoperative ischemic stroke.

关 键 词：颅内动脉瘤 体感诱发电位 运动诱发电位 

分 类 号：R651[医药卫生—外科学]