【摘要】 目的研究体感诱发电位（ＳＥＰ）神经生理监测在围脑干手术中的可行性。方法选择静脉麻醉下围脑子手术４３例，对两侧正中神经分别进行刺激，记录相应的 ＳＥＰ Ｎ２０波形，术中 Ｎ２０发生明显变化，即通知术者调整操作。结果在静脉麻醉维持过程中，波形基本保持稳定；４３例手术中ＳＥＰ发生显著变化的有８例，其中５例逐渐恢复，术后未出现新的神经功能障碍，另外３例至术终未恢复，术后均出现了相应的神经系统并发症。研究中尚未出现假阴性或假阳性病例，术中ＳＥＰ变化与术后神经功能改变存在明显的相关性。结论在围脑干手术中，ＳＥＰ是一种可靠的神经生理监测方法，静脉麻醉对于ＳＥＰ监测的实施是有益的。更多还原

【Abstract】 Objective To study the feasibility and reliability of median nerve somatosensory evoked potential monitoring in neurosurgery around the brain stem. Methods in selected 43 patients SEP N20, waveforms were recorded after stimulation of left and right median nerves respectively. Anesthesia was maintained with intravenous anesthetics throughout the operation. As soon as N20 waveform changed significantly, the surgeon was informed and the operative procedure was modified whenever possible. Results SEP waveforms were almost stable during maintaining with total intravenous anesthesia (TIVA). Within 43 cases, SEP waveform of & patients significantly changed. In these cases, SEP of 5 patients returned to normal gradually and no further neurologic dysfunction happened postoperatively. The other 3 cases did not recover, and postoperative neurologic complications happened. There was no false-negative or false-positive result. The correlation between intraoperative SEP changes and postoperative neurologic alterations was significant statistically. Conclusions SEP recording is a reliable technique for intraoperative monitoring during neurosurgery around the brain stem. TIVA is helpful for SEP monitoring.更多还原