经颅电刺激面神经运动诱发电位在听神经瘤手术中的应用  

Application of facial nerve motor evoked potential in acoustic neuroma surgery

作　　者：曾海兰[1] 杨瑞金[1] 蒋秋华[1] 宋海民[1] 罗德芳[1] 

机构地区：[1]江西省赣州市人民医院神经外科,江西赣州341000

出　　处：《中国当代医药》2016年第34期35-37,共3页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2014ZSF240)

摘　　要：目的 探讨经颅电刺激运动诱发电位（FNMEP）监测对听神经瘤术后面神经功能的预测作用。方法 选取2014年6月~2016年4月赣州市人民神经外科手术治疗的54例听神经瘤患者为研究对象,将术中行FNMEP监测面神经功能的34例听神经瘤患者视为观察组,其余20例视为对照组,术后所有患者均接受肌电图、脑干听觉诱发电位、躯体感觉诱发电位联合检测。术后参照House-Brackmann（H-B）面神经分级标准,评估两组患者术后面神经功能情况。结果 观察组术后H-BⅠ级、Ⅱ级患者30例,H-BⅢ级1例,H-BⅣ级1例,H-BⅤ级1例,H-BⅥ级1例,术后面神经功能良好30例,良好率为88.24%（30/34例）;对照组术后H-BⅠ级、Ⅱ级患者13例,H-BⅢ级2例,H-BⅣ级3例,H-BⅤ级1例,H-BⅥ级1例,术后面神经功能良好13例,良好率为65.00%（13/20例）,两组患者术后面神经功能良好率比较,差异有统计学意义（P〈0.05）。结论 FNMEP可预测术后面神经功能,可对现有术中面神经功能的监测技术起到完善、补充作用。Objective To investigate predictive effect of facial nerve motor evoked potential （FNMEP） monitoring on postoperative facial nerve function in acoustic neuroma surgery.Methods From June 2014 to April 2016,54 patients with of acoustic neuroma treated by surgery in Department of Neurosurgery of People＇s Hospital of Ganzhou City were selected as research object,facial nerve function of 34 cases among which monitored by intraoperative FNMEP were as observation group,the other 20 cases were as control group,all patients were jointly detected by electromyogram and brainstem auditory evoked potential and body sensory evoked potentials.Postoperative neurological function of two groups were evaluated by postoperative reference of House-Brackmann （H-B） facial nerve grading standards.Results In the observation group,patients of H-B grade Ⅰ and grade Ⅱ were 30 cases,1 case of H-B grade Ⅲ,1 case of H-B grade Ⅳ,1 case of H-B grade V ,1 case of H-B grade Ⅵ,postoperative facial nerve function of 30 cases were good,the good rate was 88.24% （30/34）;in the control group,patients of H-B grade Ⅰ and grade Ⅱ were 13 cases,2 cases of H-B grade Ⅲ ,3 cases of H-B grade Ⅳ,1 case of H-B grade Ⅴ,1 case of H-B grade Ⅵ,postoperative facial nerve function of 13 cases were good,the good rate was 65.00% （13/20）,the good rate of facial nerve function in two groups had significant difference （P〈0.05）.Conclusion FNMEP can predict the postoperative facial nerve function,which can improve and supplement the monitoring techniques of facial nerve function in the present operation.

关 键 词：听神经瘤 经颅电刺激运动诱发电位 面神经功能 神经功能障碍 

分 类 号：R739.4[医药卫生—肿瘤]