经颅磁刺激运动诱发电位对无骨折脱位型急性颈髓损伤的诊断意义  

Diagnostic effect of transcranial magnetic stimulation motor potential in cervical spinal cord injury without fracture and dislocation

作　　者：王博 张肖 邢其英 陈德喜 WANG Bo;ZHANG Xiao;XING Qiyin;CHEN Dexi(Department of Spine,Qingdao Traditional Chinese Medicine Hospital,Qingdao,Shandong 266000,China;Medical Laboratory,Qingdao Traditional Chinese Medicine Hospital,Qingdao,Shandong 266000,China)

机构地区：[1]青岛市中医医院脊柱外科,266000 [2]青岛市中医医院检验科,266000

出　　处：《重庆医学》2019年第A01期113-116,共4页Chongqing medicine

摘　　要：目的探讨经颅磁刺激运动诱发电位(TMS-MEP)对无骨折脱位型急性颈髓损伤患者诊治过程中的评估作用,以帮助确定其进一步的治疗方案。方法选择2015年9月至2017年9月该院收治的无骨折脱位型急性颈髓损伤患者36例,给予统一的保守治疗;72h后14例患者因病情进展给予手术治疗,设为手术组,其余22例设为非手术组;选择健康志愿者22名设为对照组,记录并比较3组研究对象JOA评分、TMS-MEP潜伏期、CMCT值等。结果3组研究对象JOA评分、MEP潜伏期、CMCT比较,差异均有统计学意义(P<0.05)。非手术组患者MEP潜伏期、CMCT在4周恢复至接近正常值,手术组患者MEP潜伏期、波幅4周后有所回升,但MEP潜伏期、CMCT仍与非手术组有明显差距。结论TMS-MEP检查对非骨折脱位型颈髓损伤患者的病损程度具有良好的相关性,对是否需手术治疗具有辅助诊断意义,并有利于预计病情的恢复情况。Objective To explore the evaluation effect of transcranial magnetic stimulation motor potential(TMS-MEP) in cervical spinal cord injury without fracture and dislocation,assisting determination of further therapeutic method. Methods 36 patients who suffered with cervical spinal cord injury without fracture and dislocation in the hospital from September 2015 to September 2017 were selected,and were given the unified conservative treatment.14 patients accepted cervical spinal surgery 72 h after injury for deteriorated spinal condition.Those 14 patients were selected as surgery group,and 22 patients else were selected as non-surgical group,22 healthy people as the control group.All the selected subjects were examined by TMS-MEP,evaluated by JOA score.The difference of JOA score、MEP latency and central motor conduction time(CMCT) were compared among the surgery group,non-surgery group and control group.The results of JOA score,MEP latency in two particular time points were compared for each other during therapy. Results There were statistically significant differences in JOA scores,MEP latency and CMCT when surgery group,non-surgery group and control group were compared for each other.MEP latency and CMCT of non-surgery group enhanced approximately to normal value during 4 weeks after injury.MEP latency and CMCT of surgery group enhanced gradually during 4 weeks after injury,which was less extended than the ones of non-surgery group. Conclusion TMS-MEP shows great relevance with the degree of cervical spinal cord injury without fracture and dislocation,which helps determining whether the surgery should be executed for the patient,and predicting the progniosis.

关 键 词：经颅磁刺激运动诱发电位 无骨折脱位型颈髓损伤 潜伏期 

分 类 号：R614[医药卫生—麻醉学]