颅神经微血管减压术中脑干听觉诱发电位波形变化与术后听力受损的相关性分析  

Analysis of association between brainstem auditory evoked potential waveform changes during cranial nerve microvascular decompression and postoperative hearing impairment

作　　者：欧昌江 吴春来 莫俊 邢如新 王铂 陈毅力 OU Changjiang;WU Chunlai;Mo Jun(The Fourth Affiliated Hospital,Zhejiang University School of Medicine,Yiwu,Zhejiang 322000,China)

机构地区：[1]浙江大学医学院附属第四医院,义乌322000

出　　处：《浙江创伤外科》2021年第2期209-212,共4页Zhejiang Journal of Traumatic Surgery

基　　金：浙江省基础公益研究计划项目(编号:LGF19H090022,LGF18H090010);义乌市科技局项目(编号:2016-S-11)。

摘　　要：目的研究颅神经微血管减压术(MVD)中脑干听觉诱发电位(BAEP)波形改变与患者术后手术侧发生听力损害的相关性。方法回顾性分析2016年7月至2018年12月在浙江大学医学院附属第四医院神经外科接受MVD治疗的连续性患者的临床资料。所有患者术中进行BAEP监测,并术前及术后1周内行纯音听阈(PTA)检查,使用二元logistic回归分析BAEP的V波潜伏期延长、V波波幅下降、V波波形消失以及性别、年龄、诊断、患侧、术前听力情况等因素与患者术后发生听力损害的相关性。结果共117例患者纳入研究,5例出现听力受损,其中4例听力轻中度下降,1例耳聋,二元logistic回归分析提示V波波幅下降≥50%或波形完全消失与患者术后听力受损明显相关(OR=20.483,95%CI:1.406~298.383,P<0.05;OR=36.493,95%CI:2.770~480.768,P<0.05)。结论 MVD术中BAEP监测出现V波的波幅明显下降或波形消失提示术后听力受损的风险增加,术中应及时采取保护措施以降低听力损害的发生率。Objective To investigate the association between the intraoperative changes of brainstem auditory evoked potential(BAEP) waveform and postoperative hearing impairment in patients receiving cranial nerve microvascular decompression(MVD). Methods Clinical data of consistent patients receiving MVD treatment from July 2016 to December 2018 in our hospital, was retrospectively analyzed. All patients underwent intraoperative BAEP monitoring and pure tone threshold(PTA) examination before and within one week after surgery. Binary logistic regression was used to analyze the correlation between postoperative hearing impairment and factors including BAEP V wave latency prolongation, BAEP V wave amplitude reduction, BAEP V wave loss,gender, age, diagnosis, affected side and preoperative hearing conditions. Results A total of 117 patients were included in the study, 5 patients showed hearing impairment, including 4 with mild or moderate hearing impairment and 1 with deafness. Binary logistic regression analysis showed that the reduction of V wave amplitude as to more than 50% or complete waveform loss were significantly correlated with postoperative hearing impairment(P <0.05). Conclusion In MVD surgeries, significant reduction of the V wave amplitude or complete waveform loss during intraoperative BAEP monitoring increase the risk of postoperative hearing impairment. Protective measures should be taken to reduce the incidence of hearing loss.

关 键 词：三叉神经痛 面肌痉挛 微血管减压 脑干听觉诱发电位 听力损害 

分 类 号：R651.1[医药卫生—外科学]