【摘要】 目的探究术中神经电生理监测(IONM)产生并发症的危险因素,旨在降低IONM产生的不良后果,提高患者生存质量。方法回顾性分析新疆医科大学第一附属医院神经外科中心自2016年9月至2020年6月行IONM的306例患者的临床资料,通过一般人口学特征、术中资料[出血量、手术时间、电极数量、最低肺泡气有效浓度(MAC)],探索术中电生理监测产生并发症的危险因素。结果 IONM术后共184例患者出现并发症:瘀青109例,头皮下血肿34例,神经损伤27例,舌咬伤9例,电烧伤3例,术中癫痫2例。年龄、BMI、糖尿病、高血压、手术时间、电极数量、MAC是术中电生理监测产生并发症的影响因素(P<0.05);Logistic回归分析得出糖尿病、高血压、电极数量、手术时间、MAC是IONM引发并发症的独立危险因素(P<0.05)。受试者工作特征曲线分析危险因素预测效能得出糖尿病、高血压、手术时间、MAC能够有效地预测IONM引发的并发症。结论糖尿病、高血压、手术时间、MAC是IONM产生并发症的危险因素,围术期减少手术时间、控制MAC可降低IONM引起并发症的风险、提高监测准确度。更多还原

【Abstract】 Objective To explore the risk factors of complications caused by intraoperative electrophysiological monitoring(IONM), in order to reduce the adverse consequences of IONM and improve the quality of life of patients. Methods The clinical data of 306 patients who underwent IONM in the Neurosurgery Center of the First Affiliated Hospital of Xinjiang Medical University from September 2016 to June 2020 were analyzed retrospectively. The risk factors of complications caused by IONM were explored through general demographic characteristics, intraoperative data [amount of bleeding, operation time, number of electrodes and minimum alveolar concentration(MAC)]. Results There were 109 cases of blood stasis, 34 cases of subcutaneous hematoma, 27 cases of nerve injury, 9 cases of tongue bite, 3 cases of electric burn and 2 cases of intraoperative epilepsy; The age, BMI,diabetes, hypertension, operation time, number of electrodes, and the MAC were different in IONM, and there were statistical differences(P<0.05). Logistic regression analysis showed that diabetes, hypertension,number of electrodes, operation time and MAC were the influencing factors of IONM induced complications(P<0.05). ROC curve analysis showed that diabetes, hypertension, operation time and MAC can effectively predict IONM and complications. Conclusion Diabetes, hypertension, operation time and MAC are the risk factors of complications during IONM. Perioperative reduction of operation time and control of anesthetic dosage can reduce the risk of complications caused by IONM and improve the accuracy of monitoring.更多还原