van Alphen H A, Polman C H
Department of Neurosurgery, Free University Hospital, Amsterdam, The Netherlands.
Acta Neurochir (Wien). 1988;91(3-4):95-9. doi: 10.1007/BF01424561.
In a retrospective study, an evaluation was made of the intra-operative EEG findings and clinical results of 100 consecutive carotid endarterectomies carried out in 90 patients over the period 1977 to 1983. There was no operation-associated mortality; the peri-operative morbidity was 5%. All operations were performed maintaining the systemic blood pressure some 20% above the patients normal value. No interval shunt was used. The surgical policy was not influenced by EEG findings in any of the procedures. There was no relationship between carotid-clamping time and intra-operative EEG changes, nor was there a relationship between EEG changes and clinical outcome. It is most likely that neurological deficit following carotid endarterectomy, if operation is performed during elevated systemic blood pressure, is not due to haemodynamic disturbances, as a consequence of critical reduction of cerebral blood flow during internal carotid artery clamping, but to micro-embolism. From this assumption, it can be concluded that peri-operative complications of carotid endarterectomy cannot be reduced by intra-operative EEG monitoring.
在一项回顾性研究中，对1977年至1983年期间90例患者连续进行的100例颈动脉内膜切除术的术中脑电图（EEG）结果和临床结果进行了评估。无手术相关死亡；围手术期发病率为5%。所有手术均在将全身血压维持在高于患者正常值约20%的情况下进行。未使用临时分流。在任何手术过程中，手术策略均不受EEG结果的影响。颈动脉夹闭时间与术中EEG变化之间无相关性，EEG变化与临床结果之间也无相关性。如果在全身血压升高期间进行手术，颈动脉内膜切除术后出现神经功能缺损很可能不是由于颈内动脉夹闭期间脑血流量急剧减少导致的血流动力学紊乱，而是由于微栓塞。基于这一假设，可以得出结论，术中EEG监测无法降低颈动脉内膜切除术的围手术期并发症。
