神经电生理监测在脑干胶质瘤患者手术中的应用  

Application of neuroelectrophysiological monitoring in brain stem glioma surgery

作　　者：许晓川 宋振全 Xu Xiaochuan;Song Zhenquan(Department of Neurosurgery,Shenyang 242 Hospital,Shenyang City,Liaoning Province,110034,China)

机构地区：[1]沈阳二四二医院神经外科,辽宁省沈阳市110034

出　　处：《现代电生理学杂志》2021年第3期142-146,共5页Journal of Modern Electrophysiology

摘　　要：目的:探讨神经电生理监测在脑干胶质瘤患者手术中的应用。方法:选取2017年6月至2019年6月期间在沈阳二四二医院神经外科进行颅脑手术治疗的82例脑干胶质瘤患者,根据患者住院号先后分为对照组和监测组,每组41例。对照组实施常规神经导航,监测组术中持续神经电生理监测,观察并比较两组围手术期状况、术后并发症发生情况、术后1年内新发的神经功能损伤事件。结果:术中同时出现SEP、MEP报警5例,BAEP报警3例,EMG报警2例。两组患者手术时间、肿瘤全切率比较差异无统计学意义(P>0.05);监测组患者Karnofsky功能状态评分较对照组升高(P<0.05)。监测组术后并发症发生率低于对照组(4.9%比36.6%,P<0.05)。监测组患者术后1年新发神经功能损伤事件发生率显著低于对照组(2.4%比31.7%,P<0.05)。结论:脑干胶质瘤患者手术中应用神经电生理监测,不会对手术时间、肿瘤全切率产生影响,且会降低术后短期并发症及新发神经功能损伤事件的风险。Objective: To explore the application of neuroelectrophysiological monitoring in brain stem glioma surgery. Methods: Eighty-two patients with brain stem glioma who underwent brain surgery in Shenyang 242 Hospital from June 2017 to June 2019, were divided into control group and monitoring group, with 41 cases in each group. Patients in the control group received routine neuronavigation, received continuous neuroelectrophysiological monitoring during operation in the monitoring group. Perioperative conditions, postoperative complications and new neurological damage events within one year after operation were observed and compared between the two groups. Results: During the operation, SEP and MEP alarms occurred in 5 cases, BAEP alarms in 3 cases and EMG alarms in 2 cases. There was no significant difference in operation time and total tumor resection rate between the two groups(P>0.05). Karnofsky functional status score in the monitoring group was higher than that in the control group(P<0.05). The incidence rate of postoperative complications in the monitoring group was lower than that in the control group(4.9% vs. 36.6%, P<0.05). The incidence rate of new neurological impairment in the monitoring group was significantly lower than that in the control group within one year after operation(2.4% vs. 31.7%, P<0.05). Conclusion: Neuroelectrophysiological monitoring in patients with brain stem glioma will not affect the operation time and the total tumor resection rate, and will reduce the risk of short-term postoperative complications and new neurological damage events.

关 键 词：神经外科手术 脑干肿瘤 电生理监测 

分 类 号：R739.41[医药卫生—肿瘤]