术中电生理监测在痉挛性脑瘫患者脊神经后根切断术中的应用  

Application of intraoperative electrophysiological monitoring in spinal nerve posterior rhizotomy in patients with spastic cerebral palsy

作　　者：薛俊刚 魏文渊 赵东升 韩超 任碧峰 李超峰 别小华 Xue Jungang;Wei Wenyuan;Zhao Dongsheng(Department of Neurosurgery,Xi'an Red Cross Hospital,Xi'an 710054,China)

机构地区：[1]西安市红会医院神经外科,710054

出　　处：《美中国际创伤杂志》2024年第3期19-22,共4页U.S.Chinese International Journal of Traumatology

摘　　要：目的:评估术中电生理监测在小儿挛性脑瘫行腰骶部脊神经后根选择性部分切断术(SPR)中的应用价值。方法:回顾性收集2019年12月至2023年12月56例在我院神经外科接受SPR的痉挛型脑瘫患者术中电生理监测资料,分为肌电监测下切断脊神经后根比例的肌电监测组(40例)及经验下切断脊神经后根比例的对照组(16),总结术中电生理监测变化与离院时手术疗效和并发症情况。结果:56例患者术前双下肢肌张力均高,无统计学差异。肌电监测指引下切断神经束相对比较保守(P<0.05),但在术后查体中发现,两种选择均可达到手术目的,疗效无明显差异(P>0.05)。结论:电生理监测技术是SPR提高手术成功率的有效方法,可提高脊神经后根切除比例的准确率,降低神经受损风险,改善不良预后。Objective:To evaluate the application value of intraoperative electrophysiological monitoring in selective partial rhizotomy(SPR)of the lumbosacral spinal nerve in children with spastic cerebral palsy.Methods:Retrospective collection of intraoperative electrophysiological monitoring data from 56 patients with spastic cerebral palsy who underwent SPR in the neurosurgery department of our hospital from December 2019 to December 2023.Divided into an electromyographic monitoring group(40 cases)and a control group(16 cases)with a proportion of spinal nerve root transection under electromyographic monitoring,summarize the changes in intraoperative electrophysiological monitoring and the surgical efficacy and complications at the time of discharge.Result:56 patients had high preoperative lower limb muscle tone,with no statistically significant difference.Under the guidance of electromyography monitoring,cutting the nerve bundle is relatively conservative(P<0.05),but during postoperative physical examination,it was found that both options can achieve the surgical purpose,and there is no significant difference in efficacy(P>0.05).Conclusion:Electrophysiological monitoring technology is an effective method for SPR to improve the success rate of surgery,improve the accuracy of posterior root resection,reduce the risk of nerve damage,and improve poor prognosis.

关 键 词：挛型脑瘫 高选择性脊神经后根切断术 术中电生理监测 

分 类 号：R47[医药卫生—护理学]