摘要
目的术中电生理监测已越来越多的应用于脊柱外科手术。文中拟探讨体感诱发电位(somatosensory evokedpotential,SEP)、运动诱发电位(motor evoked potential,MEP)在脊柱外科手术中的应用价值。方法共监测10例脊柱脊髓病变手术患者,3例术中采用SEP监测,7例术中采用SEP联合MEP监测。结果 SEP均顺利诱发并予以记录,而MEP只有3例顺利诱发并予以记录。有2例患者术中SEP的波幅较预警基准电位下降,经调整手术操作方式或停止操作后恢复;另有1例患者术后SEP的波幅升高,术后证实患者的症状较术前改善。记录到SEP的3例患者,MEP波幅和潜伏期与预警基准电位比较均无明显变化。结论脊柱外科术中行诱发电位监测,特别是SEP与MEP联合监测,能有效降低脊髓机械性损伤,保护神经功能,提高病变的切除率,增加手术的安全性,增强术者的信心。
Objective Intraoperative electrophysiological monitoring is gaining a wider application in spinal surgery. The present article is to explore the application value of somatosensory evoked potential （SEP） and motor evoked potential （MEP） in spinal surgery. Methods We employed both SEP and MEP for dynamic monitoring of 7 cases of spinal surgery, and adopted SEP alone for another 3. Results SEP was successfully induced and recorded in all the cases, while MEP only in 3 cases. Compared with preoperative forewarning potential, the wave amplitude of SEP was decreased during intraoperative monitoring in 2 cases, but restored to normal after the operation was stopped or the surgical methods adjusted. One case showed obviously improved symptoms after surgery though with an increased wave amplitude of SEP during intraoperative monitoring. No significant changes were observed in either ampli- tude or latency of the wave in the 3 cases with MEP recorded. Conclusion Evoked potential monitoring, especially with combined SEP and MEP during spinal surgery, can effectively reduce mechanical damage to nerves, increase the success rate of resection, and raise the confidence of the surgeons.
出处
《医学研究生学报》
CAS
北大核心
2013年第1期16-18,共3页
Journal of Medical Postgraduates
基金
国家自然科学基金(81100913)
南京军区医药卫生科研基金(11MA096)
关键词
脊柱外科
体感诱发电位
运动诱发电位
术中监测
Spinal surgery
Somatosensory evoked potential
Motor evoked potential
Intraoperative monitoring
