[术中运动诱发电位评估在颅内动脉瘤手术夹闭术中预测术后运动功能的应用]
[Assessment of intraoperative motor-evoked potentials for predicting postoperative motor function during the surgical clipping of intracranial aneurysms].
作者信息
Shi Chengli, Zhou Qian, Zhang Mingming, Jiang Yugang
机构信息
Department of Rehabilitation, Second Xiangya Hospital, Central South University, Changsha 410011, China.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012 Mar;37(3):244-9. doi: 10.3969/j.issn.1672-7347.2012.03.006.
OBJECTIVE
To evaluate the usefulness of monitoring transcranial electrically stimulated motor evoked potential (MEP) and its impact on postoperative motor function after surgical clipping of intracranial aneurysms.
METHODS
A total of 69 aneurysm patients were monitored for MEP during surgery. The postoperative and preoperative neurological function variation and the correlation between them were compared.
RESULTS
MEP deteriorated in 9/68 patients, 6 of the deteriorated MEP returned to normal within 1-40 min, and no new motor deficit emerged. 3 of MEP failed to return to the baseline, which were consistent with postoperative motor function deficit.
CONCLUSION
Changes in MEP could serve as early indication of the cerebral ischemia, predicting postoperative motor function and providing a guide to a safe time for temporary clipping. FNMEP monitoring is a safe and reliable tool for the integrity of facial nerve pathway in giant aneurysm surgery.
目的
评估监测经颅电刺激运动诱发电位（MEP）的作用及其对颅内动脉瘤手术夹闭术后运动功能的影响。
方法
共69例动脉瘤患者在手术期间接受MEP监测。比较术后与术前神经功能变化及其相关性。
结果
68例患者中有9例MEP恶化，其中6例恶化的MEP在1 - 40分钟内恢复正常，且未出现新的运动功能缺损。3例MEP未能恢复至基线水平，这与术后运动功能缺损相符。
结论
MEP变化可作为脑缺血的早期指标，预测术后运动功能，并为临时夹闭的安全时机提供指导。面神经运动诱发电位（FNMEP）监测是巨大动脉瘤手术中面神经通路完整性的安全可靠工具。
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