摘要
目的探讨术中联合监测体感诱发电位（SEP）、运动诱发电位（MEP）和脑电图（EEG）在颅内前循环动脉瘤手术中的应用价值。方法对2012年7月~2015年6月河南省商丘市第一人民医院神经外科收治的130例颅内前循环动脉瘤患者施行开颅夹闭术,术中联合监测SEP、MEP和EEG,并根据监测情况进行相应处理,观察手术前后患者神经功能改变情况。结果 130例颅内前循环动脉瘤夹闭术中MEP 20例、SEP 15例、EEG 5例出现异常。术后出现新的神经功能障碍的10例患者中,MEP均表现为异常,SEP 7例异常,EEG 2例异常。结论在颅内前循环动脉瘤夹闭术中神经电生理监测结果与术后神经功能改变具有很好的一致性。对于运动系统缺血性损伤的敏感性,MEP监测优于SEP监测,EEG监测最低。SEP、MEP、EEG联合监测下手术可有效降低术后神经功能障碍的发生率,增加手术的安全性,提高患者生存质量。
Objective To investigate the application value of combined monitoring of somatosensory evoked potentials（SEP）, motor evoked potentials（MEP）, and electroencephalogram（EEG） during intracranial anterior circulation aneurysms surgery. Methods One hundred and thirty cases of patients with intracranial anterior circulation aneurysms admitted to the First People＇s Hospital of Shangqiu City from July 2012 to June 2015 were performed craniotomy clipping with monitoring of SEP, MEP and EEG, and the appropriate treatment was done based on monitoring situation. Neurological changes were observed before and after surgery. Results In 130 cases with intracranial anterior circulation aneurysm clipping, 20 cases of MEP, 15 cases of SEP and 5 cases of EEG showed abnormal. 10 patients developed advanced nerve dysfunction after surgery and all of them showed MEP abnormal, with 7 cases of SEP abnormal and 2 cases of EEG abnormal. Conclusion The neural electrophysiological monitoring results and postoperative nerve function change has good consistency in the patients with intracranial anterior circulation aneurysms clipping. The MEP is more sensitive than SEP in monitoring the motor ischemic impairments, while EEG is the most insensitive. The combined monitoring of SEP, MEP and EEG may be helpful to reduce the ratio of postoperative neurological deficits, to increase surgical safety, and to improve the quality of life.
出处
《中国医药导报》
CAS
2016年第11期80-83,共4页
China Medical Herald
关键词
颅内前循环动脉瘤
显微外科手术
诱发电位
脑电图
Intracranial anterior circulation aneurysms
Microsurgery
Evoked potential
Electroencephalogram
