Tiel R L, Happel L T, Kline D G
Department of Neurosurgery, Louisiana State University, New Orleans, USA.
Neurosurgery. 1996 Jul;39(1):103-8; discussion 108-9. doi: 10.1097/00006123-199607000-00019.
Nerve action potential (NAP) recording is a proven and useful tool in the surgical management of nerve injury. Understanding its materials and methods as well as its pitfalls and limitations is necessary for successful and routine use of this tool.
The basic electrophysiology of nerve and its implications in the setting of nerve trauma and regeneration are reviewed. Electrode design and electrode placement are discussed. The use of simple electromyographic/nerve conduction machines for intraoperative recording of NAPs is developed, along with some of the technical problems that result from electrophysiological recording in an electrically hostile environment.
NAP recording is a good indicator of useful recovery in nerve trauma. The presence and demonstration of an NAP is associated with a 90% chance of recovery to a useful motor state.
NAP recording provides useful information regarding the regenerative potential of a damaged nerve long before that potential is clinically evident. This information is critical in the optimal management of nerve injuries. The techniques of NAP recording are straightforward, but attention to detail is important, and full understanding of the method is required.
神经动作电位（NAP）记录是神经损伤外科治疗中一种经过验证且实用的工具。要成功且常规地使用该工具，了解其材料和方法以及其陷阱和局限性是必要的。
回顾神经的基本电生理学及其在神经创伤和再生情况下的意义。讨论电极设计和电极放置。阐述了使用简单的肌电图/神经传导仪在术中记录NAP，以及在电干扰环境中进行电生理记录所产生的一些技术问题。
NAP记录是神经创伤中有用恢复的良好指标。NAP的存在和显示与恢复到有用运动状态的90%概率相关。
NAP记录在受损神经的再生潜力在临床上明显显现之前很久就能提供有关该潜力的有用信息。这些信息对于神经损伤的最佳管理至关重要。NAP记录技术简单直接，但注重细节很重要，并且需要对该方法有充分的理解。
