体感诱发电位在椎管内占位显微手术中的监测

目的　评价体感诱发电位 (SEP)在神经外科脊髓疾病显微手术中的监测作用 ,避免或减少医源性脊髓损伤。方法　 2 8例病人行术前、术中SEP全程监测 ,包括脊髓SEP(SSEP)及皮层SEP(CSEP) ,术中及时把监测信息反馈给术者。并将术中监测结果与术后疗效对照分析。结果　椎管内占位手术在行髓内肿瘤切除时最易引发SEP波幅降低及潜时延长。术中监测按Frankel分级D、E级患者波幅较基准电位下降不超过 50 % ,潜伏期延长不超过7% ;B、C级患者波幅较基准电位下降不超过 40 % ,潜伏期延长不超过 5 %。术后不会引起脊髓功能不可逆损害。结论　脊髓手术时行SSEP和CSEP联合监测可及时反映出脊髓功能的变化 ,提高术者术中操作的安全性 ,避免或减少术后并发症

EVALUATION ON MONITORING OF SEP IN MICROSURGERY FOR TUMOR IN SPINE CANAL

Objective\ To evaluate monitoring of SEP in microsurgery for extramedullary or intramedullary tumor.Methods\ SSEP and CSEP monitoring have been performed preoperatively and postoperatively in 28 patients.Results\ Dissection of intramedullary tumor usually led to reduction of amplitude and increase of latency in SEP.The irreversible injury to spinal cord did not exist postoperatively if the amplitude of SEP decreased by less than 40% of normal potential or if delay of latency was less than 7% for Frankel D,E;40%,5% for B,C.Conclusion\ Intraoperative monitoring of SSEP and CSEP may reduce the risk of iatrogenic injury to spinal cord and avoid postoperative complication.