神经电生理监测对微创心脏手术患者脑脊髓损伤的评估价值  

The value of intraoperative neurophysiological monitoring in the assessment of brain and spinal cord injury in patients with minimally invasive cardiac surgery

作　　者：王韬甫 吴亚辉 王圣 张志东 梁维杰 林洪启 程兆云 Wang Taofu;Wu Yahui;Wang Sheng;Zhang Zhidong;Liang Weijie;Lin Hongqi;Cheng Zhaoyun(Fuwaihua Central Vascular Hospital,Heart Center,Henan Provincial People’s Hospital,Zhengzhou 450000,China;Department of Adult Cardiac Surgery,Fuwaihua Central Vascular Hospital,Henan Provincial People’s Hospital,Zhengzhou 450000,China;Department of Minimally Invasive Cardiac Surgery,Fuwaihua Central Vascular Hospital,Henan Provincial People’s Hospital,Zhengzhou 450000,China;Fuwaihua Central Vascular Hospital,Children’s Heart Center,Henan Provincial People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]阜外华中心血管病医院河南省人民医院心脏中心,郑州450000 [2]阜外华中心血管病医院,河南省人民医院心脏中心成人心脏外科,郑州450000 [3]阜外华中心血管病医院,河南省人民医院心脏中心大血管外科,郑州450000 [4]阜外华中心血管病医院,河南省人民医院儿童心脏中心,郑州450000

出　　处：《中华实验外科杂志》2022年第8期1480-1483,共4页Chinese Journal of Experimental Surgery

摘　　要：目的分析神经电生理监测(IOM)对微创心脏手术患者脑脊髓损伤的评估价值。方法选取2019年3月至2022年1月期间我院收治的126例进行微创心脏外科手术患者为研究对象, 将其采用简单随机法分为两组, 对照组和观察组各63例, 观察组术中联合使用神经电生理监测。比较两组的各项一般性指标、神经系统并发症和脑脊髓神经功能。计量资料、计数资料比较分别采用t检验、χ^(2)检验、秩和检验, 以P<0.05为差异有统计学意义。结果观察组的脱机拔管时间、重症监护室(ICU)滞留时间低于对照组[(10.72±2.08) h比(13.58±2.12) h、(3.10±1.06) d比(5.48±1.24) d, t=2.037、2.517, P<0.05], 观察组的术后神经系统并发症总发生率低于对照组[23.81%(15/63)比55.56%(35/63), χ^(2)=4.612, P<0.05], 观察组术后的脑脊髓神经功能分级优于对照组[98.41%(62/63)比90.48%(57/63), Z=8.231, P<0.05]。结论神经电生理监测用于微创心脏外科手术中能够促进患者术后恢复, 降低术后神经系统并发症的发生, 减少脑脊髓损伤。Objective To analyze the evaluation value of intraoperative neurophysiological monitoring(IOM)for brain and spinal cord injury in patients with minimally invasive cardiac surgery.Methods A total of 126 patients who underwent minimally invasive cardiac surgery in our hospital from March 2019 to January 2022 were selected as the research objects,and randomly divided into two groups by simple random method,with 63 cases in the control group and the observation group,and the observation group was given intraoperative neurophysiological monitoring.The general indexes,neurological complications and cerebrospinal nerve function were compared between the two groups.T test,Chi-square test and rank sum test were used to compare measurement data and count data,respectively.P<0.05 was considered statistically significant.Results The weaning time and intensive care unit(ICU)stay time in the observation group were shorter than those in the control group[(10.72±2.08)h vs.(13.58±2.12)h,(3.10±1.06)d vs.(5.48±1.24)d,t=2.037,2.517,P<0.05].The total incidence of postoperative neurological complications in the observation group was lower than that in the control group[23.81%(15/63)vs.55.56%(35/63),χ^(2)=4.612,P<0.05],and the neurospinal neurological function grading in the observation group was better than that in the control group (98.41%(62/63)vs.90.48%(57/63),Z=8.231,P<0.05).Conclusion Neuroelectrophysiological monitoring in minimally invasive cardiac surgery can promote postoperative recovery,reduce postoperative nervous system complications,and reduce cerebrospinal cord injury.

关 键 词：微创心脏外科手术 神经电生理监测 脑脊髓损伤 疗效 

分 类 号：R654.2[医药卫生—外科学] R651.2[医药卫生—临床医学]