摘要
目的 探讨躯体感觉诱发电位 (SEP)在脊柱手术监护中的应用价值。方法 分析 45 8例脊柱手术中SEP监护的结果、特征、适用范围。其中颈部手术 2 75例 ,胸椎、腰椎部手术 183例 ,刺激电极为手指、足趾的环状电极或腕、踝的的表面电极 ,记录电极为头皮针电极。结果 大部分患者的肌电图改变在器质性改变的范围内。 40 9例 (89 3% )术中SEP有波幅轻度下降 ,潜伏期轻度延长 ,术后又恢复到近手术开始时水平 ;32例 (7 1% )SEP波幅有一定程度的提高 ,潜伏期部分缩短 ;12例(2 6 % )有术中SEP明显恢复 ;2例 (0 4% )术中未见SEP明显改变 ,术后有功能障碍 ;3例 (0 7% )术中出现SEP的波幅明显下降 ,潜伏期轻度延长 ,术后恢复欠佳。结论 SEP在脊柱手术监护中的作用是肯定的 ,但有一定的局限性。
Objective To analyse the value of somatosensory evoked potentials (SEP) used as an intraoperative monitoring method in the spinal surgery. Methods 458 cases of spinal surgery were performed with an intraoperative SEP monitoring, 275 cases with cervical operations, the other 183 cases with thoracic and lumbar operations. The stimulating electrodes were ring electrode attached to the fingers or toes and disc electrodes attached to the wrists or ankles, the needle electrodes nailed to the scalp were used as the recording electrode. Results Most electromyogram recorded changed within the material limit, 409 cases (89.3%) had a slightly lowered amplitude and prolonged latent period of SEP during the operation, but recovered nearly to the former level at the end of the operation,32(7 1%) cases showed a rise of the SEP amplitude and a shortening of the latent, 12(2 6%) cases improved markedly during the operation, 2 cases (0 4%) did not show SEP change but had a malfunction after the operation, 3 cases (0 7%) showed evidently fall of the amplitude and slightly prolonged latent who had a poor recovery. Conclusion Although SEP has its limitation, it is still a valuable monitoring method in spinal surgery.
出处
《临床骨科杂志》
2000年第4期247-250,共4页
Journal of Clinical Orthopaedics
