围手术期神经电生理监测下手术治疗96例儿童脊髓栓系综合征报道  

Perioperative electro-neurophysiologv monitoring guided surgery for 96 children with tethered cord syndrome

作　　者：费喜云 廖宇翔 张治平[1] 刘景平[1] Fei Xiyun;Liao Yuxiang;Zhang Zhiping;Liu Jingping(Department of Neurosurgery,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院神经外科,长沙410008

出　　处：《中华神经医学杂志》2021年第12期1258-1261,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨围手术期神经电生理监测下脊髓栓系松解术治疗儿童脊髓栓系综合征的应用价值。方法对中南大学湘雅医院小儿神经外科自2015年1月至2019年12月收治的96例脊髓栓系综合征患儿施行脊髓栓系松解术治疗,并在围手术期采用神经电生理监测评价是否存在神经功能损伤,回顾性总结分析患儿的手术效果、神经电生理监测效果及随访结果。结果96例患儿中,术后症状消失45例、症状明显好转34例、症状无缓解10例、症状恶化3例、再次栓系4例,总有效率达82.6%,无死亡病例;术前神经电生理监测示下肢感觉、运动功能异常40例,术后示下肢感觉、运动功能异常加重6例;平均随访13个月,疗效为好转者79例、稳定者10例、加重者7例。结论对于儿童脊髓栓系综合征,无论早期有无神经功能损伤,尽早行脊髓栓系松解术可获得良好疗效;围手术期应用神经电生理监测可有效保护脊髓功能,防止神经功能损伤,有利于提高手术的安全性和改善患儿的预后。Objective To explore the application value of microsurgical tethered cord release in children with tethered cord syndrome under perioperative electro-neurophysiology monitoring.Methods Ninety-six patients with tethered cord syndrome accepted tethered cord release in our hospital from January 2015 to December 2019 were chosen in our study;perioperative electroneurophysiology monitoring was performed to evaluate whether there was neurological impairment.The surgical results,neuroelectrophysiological monitoring results,and follow-up results were retrospectively analyzed.Results In these 96 patients,symptoms disappeared in 45 patients,improved in 34,not improved in 10,worsened in 3,and tethered again in 4 patients,with a total effective rate of 82.6%.No death was noted.Preoperative neuroelectrophysiological monitoring showed abnormal sensory and motor functions of lower limbs in 40 patients,and postoperative monitoring showed abnormal sensory and motor functions of lower limbs in 6 patients.Follow up was performed for an average of 13 months;symptoms improved in 79 patients,stabilized in 10 patients,and aggravated in 7 patients.Conclusion In children with tethered cord syndrome,tethered cord release should be performed as soon as possible regardless of early neurological injury;perioperative electroneurophysiology monitoring can protect spinal cord function,prevent nerve function injury,improve the surgical safety and improve the prognosis of these children.

关 键 词：脊髓栓系综合征 脊髓栓系松解术 神经电生理监测 儿童 

分 类 号：R726.5[医药卫生—儿科]