【摘要】 目的探讨皮层体感诱发电位(CSEP)和经头颅电刺激运动诱发电位(TES-MEP)在胸椎结核患者术中联合应用的价值。方法对27例胸椎结核患者行术中CSEP+TES-MEP联合监护。术中持续观察CSEP及TES-MEP波幅及潜伏期变化,出现波幅下降50%、潜伏期延长10%或刺激强度高于初始刺激强度100 V仍未引出者,停止手术并对症处理。结果 CSEP监测成功率为100.0%(27/27),TES-MEP监测成功率为92.6%(25/27),联合监测成功率为92.6%(25/27),CSEP阳性1例,TES-MEP阳性7例,其中,CSEP+TES-MEP均为阳性的1例,CSEP阴性而TES-MEP阳性6例,术后神经功能损伤1例。结论胸椎结核患者术中联合运用CSEP和TES-MEP监测,排除各种干扰因素后,能准确地反映术中脊髓功能状况,提高监护效果。更多还原

【Abstract】 Objective To investigate the combined application value of cortical somatosensory evoked potentials(CSEP) and transcranial electrical stimulation motor evoked potentials(TES-MEP) in thoracic vertebral tuberculosis surgery.Methods 27 cases of patients with thoracic vertebral tuberculosis were given CSEP + TES-MEP monitoring during surgery.Amplitude and latency changes of CSEP and TES-MEP were observed continuously during surgery.Patients whose amplitude decreased by 50%,latency extended by 10% or 100 V stimulus intensity higher than the initial stimulus intensity yet failed to extract,were stopped the surgery and conducted symptomatic treatment.Results The success rate of CSEP monitoring was 100.0%(27/27),which of TES-MEP was 92.6%(25/27),and the success rate of combined monitoring was 92.6%(25/27).CSEP showed 1 positive case and TES-MEP showed 7 positive cases,of which 1 case was positive in both CSEP and TES-MEP,6 cases were negative in CSEP and positive in TES-MEP,and 1 case was postoperative neural function injury.Conclusion Combined application of CSEP and TES-MEP in the thoracic vertebral tuberculosis surgery can accurately reflect the intraoperative spinal function and improve the monitoring effects,after excluding various interference factors.更多还原