经颅电刺激运动诱发电位术中监测预防脊髓缺血性损伤的实验研究

被引：10

作者：

宋启民

杨卫忠

陈春美

王春华

石松生

贾建文

房新蓉

机构：

[1] 福建医科大学附属协和医院神经外科福建省神经外科研究所

来源：

中国微侵袭神经外科杂志 | 2010年 / 15卷 / 03期

关键词：

脊髓损伤; 诱发电位,运动; 监测,手术中; 经颅电刺激; 兔子;

D O I：

暂无

中图分类号：

R651.2 [脊髓];

学科分类号：

100223 [神经外科学];

摘要：

目的探讨术中经颅电刺激运动诱发电位(TceMEP)监测在脊髓髓内肿瘤切除术中对脊髓缺血性损伤的保护作用。方法将16只实验兔随机分为4组,4只/组;对照组用来确定TceMEP的最佳刺激强度,术前连续记录3h(30min/次),并于术中、术后不同时间点记录以排除麻醉、手术对诱发电位的影响;另3组分别结扎3、4、5根腰动脉,血管结扎后5min内记录TceMEP,并行运动功能评分,2d后取标本行苏木精-伊红染色。结果TceMEP波幅对缺血性脊髓损伤敏感;血管结扎后,可见波幅先降低后逐渐恢复,5min内均趋于稳定。TceMEP波幅变化与麻醉清醒后运动功能、结扎2d后运动功能和病理损伤程度均呈正相关,r分别为0.977、0.933、0.971,差异均有统计学意义(P<0.01)。结论术中TceMEP可敏感地反映缺血性脊髓损伤,可在脊髓缺血可逆期内发现缺血性损伤,有助于及时采取措施,预防不可逆性脊髓损伤的发生。

引用

页码：127 / 130

页数：4

共 12 条

[1]

Intraoperative Multimodality Monitoring in Adult Spinal Deformity Analysis of a Prospective Series of One Hundred Two Cases With Independent Evaluation [J].

Quraishi, Nasir A. ;

Lewis, Stephen J. ;

Kelleher, Michael O. ;

Sarjeant, Roger ;

Rampersaud, Yoga R. ;

Fehlings, Michael G. .

SPINE, 2009, 34 (14) :1504-1512

[2]

Motor evoked potential monitoring improves outcome after surgery for intramedullary spinal cord tumors: A historical control study [J].

Sala, Francesco ;

Palandri, Giorgio ;

Basso, Elisabetta ;

Lanteri, Paola ;

Deletis, Vedran ;

Faccioli, Franco ;

Bricolo, Albino .

NEUROSURGERY, 2006, 58 (06) :1129-1141

[3]

The value of motor and somatosensory evoked potentials in evaluation of cervical myelopathy in the presence of peripheral neuropathy [J].

Chistyakov, AV ;

Soustiel, JF ;

Hafner, H ;

Kaplan, B ;

Feinsod, M .

SPINE, 2004, 29 (12) :E239-E247

[4]

Real-time continuous intraoperative electromyographic and somatosensory evoked potential recordings in spinal surgery: correlation of clinical and electrophysiologic findings in a prospective, consecutive series of 213 cases [J].

Gunnarsson, T ;

Krassioukov, AV ;

Sarjeant, R ;

Fehlings, MG .

SPINE, 2004, 29 (06) :677-684

[5]

Current practice of motor evoked potential monitoring: Results of a survey [J].

Legatt, AD .

JOURNAL OF CLINICAL NEUROPHYSIOLOGY, 2002, 19 (05) :454-460

[6]

Identification of the critical spinal arteries with F wave–polysynaptic response complex monitoring: An experimental study.[J].Keiji Iyori;Kihachiro Kamiya;Osamu Suzuki;Atsuo Kojima;Kenji Kubota;Tadao Ishimoto;Masahiro Kobayashi;Shunya Shindo;Yusuke Tada.Journal of Vascular Surgery.2001, 2

[7]

Development of spinal cord ischemia after clamping of noncritical segmental arteries in the pig [J].