Schweiger H, Kamp H D, Dinkel M
Department of Surgery, University of Erlangen-Nürnberg, Federal Republic of Germany.
Surgery. 1991 May;109(5):602-9.
A prospective study was undertaken to determine the efficacy of monitoring somatosensory-evoked potentials (SEP) during carotid artery surgery in predicting a new ischemic neurologic deficit. Three hundred seventy-six patients underwent 400 reconstructions of the internal carotid artery. The mortality rate of the entire series was 0.8%. In 383 procedures, SEP amplitudes were always present during cross-clamping of the internal carotid artery. In spite of that, three neurologic deficits occurred, but all were associated with technical failures and not related to clamping ischemia. Complete loss of SEP amplitudes was noted in 17 procedures. Five of seven patients without an indwelling shunt showed a neurologic deficit after surgery, whereas shunt insertion in 10 resulted in three neurologic deficits. It is concluded that at present SEP recording is an accurate monitoring method in detecting clamping-related cerebral ischemia during carotid artery surgery.
进行了一项前瞻性研究，以确定在颈动脉手术期间监测体感诱发电位（SEP）对预测新的缺血性神经功能缺损的有效性。376例患者接受了400次颈内动脉重建术。整个系列的死亡率为0.8%。在383例手术中，颈内动脉交叉夹闭期间SEP波幅始终存在。尽管如此，仍发生了3例神经功能缺损，但均与技术失误有关，与夹闭缺血无关。在17例手术中记录到SEP波幅完全消失。7例未留置分流管的患者中有5例术后出现神经功能缺损，而10例插入分流管的患者中有3例出现神经功能缺损。结论是，目前SEP记录是检测颈动脉手术期间与夹闭相关的脑缺血的一种准确监测方法。
