神经电生理监测在重度腰椎滑脱矫正手术中的应用  

Application of electroneurophysiological monitoring in the treatment of severe lumbar spondylolisthesis

作　　者：郭朝阳[1] 卢志军[1] 曹鲁军 伍耀宏 GUO Chaoyang;LU Zhijun;CAO Lujun(Ganzhou People's Hospital,Ganzhou,341000,Jiangxi,China)

机构地区：[1]赣州市人民医院,江西赣州341000 [2]宁都县人民医院

出　　处：《癫痫与神经电生理学杂志》2020年第2期69-75,共7页Journal of Epileptology and Electroneurophysiology(China)

基　　金：江西省卫生计生委科技计划(NO:20187245)。

摘　　要：目的:对神经电生理监测用于重度腰椎滑脱矫正手术中的价值进行研究,为其临床推广应用提供数据支持。方法:选取江西赣州市人民医院2016年6月至2018年6月间手术矫正的重度腰椎滑脱病例20例作为研究对象,对神经电生理监测的操作方法、报警次数、手术疗效、手术时间、手术安全性及随访1年患者的生活品质、滑脱复位情况(椎间隙高度、滑脱率、滑脱角)等数据进行分析。结果:病例的总有效率为95%;手术时间在125?168 min,平均(146.38±16.56)min;并发症发生率为20%;随访1年病例的生理健康评分为(22.48±3.26)分,心理健康评分为(16.43±2.65)分,社会关系评分为(17.36±4.25)分,周围环境评分为(23.38±3.66)分,生存质量测定量表(QOL-100)量表总分为(75.48±3.76)分,较术前显著增髙(P<0.05);术后1年本组患者椎间隙高度(12.60±1.77)mm、滑脱角(7.18±1.59)°较术前增大,滑脱率(3.91±1.33)%较术前缩小,差异有统计学意义(P<0.05)。结论:神经电生理监测用于重度腰椎滑脱矫正手术能够提高手术的安全性,对术中矫形程度有指导意义,改善随访1年病例的生活品质及滑脱复位情况,且不延长手术时间,用于临床具有实用价值。Objective:To study the value of neuroelectrophysiological monitoring in the corrective surgery of severe lumbar spondylolisthesis(SLS),and to provide data support for its clinical application.Methods:20 cases of SLS by corrective surgeries from June 2016 to June 2018 in Ganzhou People's Hospital of Jiangxi China were selected as the research objects.The data of neuroelectrophysiological monitoring in operation method,alarm times,operation effect,operation time,operation safety,quality of life,reduction of spondylolisthesis(intervertebral height,spondylolisthesis rate,spondylolisthesis angle)and other data were analyzed.Results:The total effective rate of the corrective surger ies was 95%.The average operative time was(146.38±16.56)minutes in 125?168 minutes,and the incidence of complications was 20%.The physical health score,mental health score,social relationship score and surrounding environment score were(22.48±3.26),(16.43±2.65),(17.36±4.25)and(23.38±3.66)respectively.The total score of QOL-100 was(75.48±3.76).One year after operation,the height of the intervertebral space and the angle of slippage of the patients were(12.60±1.77)mm and(7.18±1.59)°,higher than those of the patients before operation.and the rate of slippage was(3.91±1.33)%,lower than ihose before operation,and the difference was statistically significant(P<0.05).Conclusion:The application of neuroelectrophysiological monitoring in the corrective surgeries of SLS can upgrade the safety,guide the corrective degree,improve the quality of life and the reduction of spondylolisthesis for the patients of one-year follow-up,and do not extend the operation time,so it is of clinical value.

关 键 词：神经电生理监测 重度腰椎滑脱 矫正手术 疗效 生存品质 安全性 

分 类 号：R741.044[医药卫生—神经病学与精神病学] R687.3[医药卫生—临床医学]