Department of Anesthesiology, Hangzhou Fuyang Hospital of Orthopedics of Traditional Chinese Medicine, Hangzhou, Zhejiang 311400, China.
Contrast Media Mol Imaging. 2023 Feb 20;2023:1484802. doi: 10.1155/2023/1484802. eCollection 2023.
To study the application of intraoperative EMG intelligent monitoring in orthopedic surgery under general anesthesia, a total of 53 patients who underwent orthopedic surgery from February 2021 to February 2022 were selected. The combined monitoring of somatosensory evoked potential (SEP), motor evoked potential (MEP), and electromyography (EMG) was used to analyze the monitoring efficiency. In 38 of the 53 patients, the intraoperative signal was normal, and there was no postoperative neurological dysfunction; one case had abnormal signal, and the abnormality still existed after debugging, but no obvious neurological dysfunction was found after operation; the remaining 14 cases had abnormal signal. There were 13 early warnings in SEP monitoring; 12 early warnings in MEP monitoring; 10 early warnings in EMG monitoring. There were 15 cases of early warning in the joint monitoring of the three, and the sensitivity of the combined monitoring of SEP + MEP + EMG was significantly higher than that of the single monitoring of SEP, MEP, and EMG ( < 0.05). There was no significant difference in specificity, positive predictive value, and negative predictive value between combined monitoring and single monitoring ( > 0.05). The combined monitoring of EMG, MEP, and SEP in orthopedic surgery can significantly improve the safety of surgery, its sensitivity and negative predictive value were significantly higher than the monitoring effects of the two alone.
为了研究术中肌电图智能监测在全麻骨科手术中的应用,选取 2021 年 2 月至 2022 年 2 月接受骨科手术的 53 例患者。采用体感诱发电位(SEP)、运动诱发电位(MEP)和肌电图(EMG)联合监测,分析监测效果。53 例患者中,38 例术中信号正常,术后无神经功能障碍;1 例信号异常,调试后仍异常,但术后无明显神经功能障碍;其余 14 例信号异常。SEP 监测中有 13 次预警;MEP 监测中有 12 次预警;EMG 监测中有 10 次预警。三者联合监测预警 15 例,SEP+MEP+EMG 联合监测的灵敏度明显高于 SEP、MEP 和 EMG 单项监测(<0.05)。联合监测与单项监测的特异性、阳性预测值和阴性预测值差异无统计学意义(>0.05)。肌电图、MEP 和 SEP 在骨科手术中的联合监测可显著提高手术安全性,其灵敏度和阴性预测值明显高于两种监测方法的单独监测效果。