术中多模式神经电生理监测在脊柱手术中的应用  

Application of intraoperative multimodal neuroelectrophysiological monitoring in spinal surgery

作　　者：谢云 Xie Yun(Department of Anesthesiology and Surgery,the First Affiliated Hospital of Nanchang University,Nanchang City,Jiangxi Province,330006,China)

机构地区：[1]南昌大学第一附属医院麻醉手术部,江西省南昌市330006

出　　处：《现代电生理学杂志》2025年第1期14-17,共4页Journal of Modern Electrophysiology

摘　　要：目的 探讨术中多模式神经电生理监测在脊柱手术中的应用。方法 收集2020年1月至2023年12月南昌大学第一附属医院收治的脊柱手术患者90例,其中男性48例,女性42例,年龄18~60岁。按照随机数字表法分为对照组与观察组,每组45例。对照组采用单模式体感诱发电位(SEP)监测,观察组采用经颅电刺激运动诱发电位(TES-MEP)、SEP和肌电图多模式监测。观察电生理监测异常及预警情况,采用脊髓损伤独立性评估量表(SCIM)对患者脊髓及神经功能进行评价,采用SF-36生活简易量表对生活质量进行评价。结果 观察组患者电生理异常检出率及预警率均高于对照组(P<0.05)。术后,两组患者SCIM及SF-36各项评分均高于术前,且观察组高于对照组(P均<0.05)。观察组神经系统并发症发生率明显低于对照组(2.2%比17.8%,P=0.014)。结论 术中多模式神经电生理监测能够提高脊髓运动功能,降低患者术后神经系统并发症的发生,促进患者术后恢复和生活质量的提高。Objective To explore the application of intraoperative multimodal neuroelectrophysiological monitoring in spinal surgery.Methods A total of 90 patients undergoing spinal surgery admitted to the First Affiliated Hospital of Nanchang University from January 2020 to December 2023 were screened,including 48 males and 42 females,aged 18 to 60 years.According to random number table method,the patients were divided into control group and observation group,45 cases in each group.Patients was monitored by single mode somatosensory evoked potential(SEP)in the control group,combined with transcranial electrical stimulation motor evoked potential(TES-MEP),SEP and electromyography in the observation group.Abnormal electrophysiological monitoring and warning situations were observed.The spinal cord and nerve function were evaluated by the spinal cord injury independence measure scale(SCIM),and the quality of life was evaluated by the SF-36 simple life scale.Results The detection rate and early warning rate of electrophysiological abnormalities in the observation group were higher than those in the control group(P<0.05).After surgery,the scores of SCIM and SF-36 in the two groups were higher than those before surgery,and which were higher in the observation group than those in the control group(P<0.05).The incidence of postoperative neurological complications in the observation group was lower than that in the control group(2.2%vs.17.8%,P=0.014).Conclusion Intraoperative multi-mode neuroelectrophysiological monitoring can improve spinal motor function,reduce the occurrence of postoperative neurological complications,and promote postoperative recovery and improve the quality of life.

关 键 词：脊柱 电生理学 诱发电位 躯体感觉 肌电描记术 诱发电位 运动 

分 类 号：R47[医药卫生—护理学]