神经电生理监测桥小脑角手术的研究(附106例报告)  

Intraoperative eletroneurophilogy monitoring in the cerebellopontine angle operation:report of 106 cases

作　　者：乔慧[1] 于春江[2] 刘淑玲[1] 江涛[2] 

机构地区：[1]北京市天坛医院神经外科 [2]北京市神经外科研究所,北京100050

出　　处：《中国微侵袭神经外科杂志》2004年第3期101-103,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：卫生部基金资助项目(982245)

摘　　要：目的探讨桥小脑角(CPA)手术中行神经电生理监测的意义。方法对106例CPA肿瘤病人进行了术中神经电生理监测,主要包括面神经、三叉神经、后组颅神经以及健侧脑干听觉诱发电位(BAEP)监测,观察术后面神经功能及并发症。结果面神经解剖保留96例(91%),面神经功能Ⅰ、Ⅱ级57例(54%),Ⅲ、Ⅳ级42例(40%),Ⅴ、Ⅵ级7例(6%)。术中健侧BAEP变化最明显的是Ⅲ～Ⅴ、Ⅰ～Ⅴ峰间潜伏期。结论在CPA手术中,采用诱发电位、肌电图实时监测,可及时为术者提供脑干功能的情况;术中健侧BAEP的Ⅰ～Ⅴ、Ⅲ～Ⅴ峰间潜伏期是重要监测指标;术中肌电图监测可以提示颅神经的位置和走行,为手术时避免损伤神经提供依据。Objective To explore the effect of brain stem auditory evoked potentials (BAEP) and electromyography (EMG) on cerebellopontine angle (CPA) operations. Methods 106 patients have been monitored during the resection of CPA tumors with BAEP and EMG, including facial nerve monitoring and contralateral BAEP. Post-operative neurologic deficits and complications were compared. Results Facial nerves were anatomically preserved in 96 patients (91%). H-B grading was valuated: I and II 57 cases (54%), III and IV 42 cases (40%), V and VI 7 cases (6%). It was most significantly that III-V and I-V interpeak latency changed intraoperatively, demonstrated by contralateral BAEP monitoring. Conclusion Contralateral BAEP monitoring is useful in assessing the function of brain stem during tumor resection; III-V and I-V interpeak latency are important index. Intraoperative EMG monitoring is a suitable technique for early nerve identification and nerve preservation.

关 键 词：神经电生理 桥小脑角 脑外科手术 听神经鞘瘤 神经损伤 

分 类 号：R739.41[医药卫生—肿瘤]