皮质脑电图与头皮脑电图同时监测在前循环颅内动脉瘤术中的应用
피질뇌전도여두피뇌전도동시감측재전순배로내동맥류술중적응용
Application of simultaneous monitoring of cortical EEG and scalp EEG during anterior circulation aneurysm surgery
  • 万方数据
    国际脑血管病杂志 국제뇌혈관병잡지
    INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
    2009年 4期 292-296 ,共5页

    宋志俊%田蕾%史继新%潘灏%孙康健%杭春华%谢%樊友武%潘云曦%马驰原%李杰%李劲松%张庆荣%张鑫%成惠林%王汉东

    송지준%전뢰%사계신%반호%손강건%항춘화%사%번우무%반운희%마치원%리걸%리경송%장경영%장흠%성혜림%왕한동

    脑电描记术%颅内动脉瘤%麻醉%监测,手术中 腦電描記術%顱內動脈瘤%痳醉%鑑測,手術中
    뇌전묘기술%로내동맥류%마취%감측,수술중
    electroencephalography%intracranial aneurysm%anesthesia%monitoring,intraoperative
    目的 探索一种监测前循环颅内动脉瘤术中载瘤动脉临时阻断后皮质缺血的简单、有效的方法.方法 2008年4-11月期间,对接受开颅手术治疗的52例前循环动脉瘤患者(58个动脉瘤)同时进行术中皮质脑电图和头皮脑电图临测.根据国际10/20系统将头皮电极置于O1、02、P3、P4、15和T6,用于监测麻醉深度变化;条形皮质电极置于术中可能阻断动脉的供血皮质表面,用于监测町能的皮质缺血.对临时阻断载瘤动脉后皮质脑电图出现抑制者与头皮脑电图变化进行比较,术后观察有无阻断血管相应供血区的缺血事件.结果 在58个动脉瘤中,有40个动脉瘤和41条主要动脉在术中采取了临时阻断,18例患者的19条血管临时阻断后,皮质脑电图有明显变化,而头皮脑电图无明显变化.术后仅在皮质脑电图明显变化组出现阻断血管相应供血区的缺血事件9例.麻醉深度改变对皮质和头皮脑电图影响一致.结论 同时监测皮质和头皮脑电图是监测前循环颅内动脉瘤术中皮质缺皿的一种简单、有效的方法,并可有效辨别麻醉对脑电图的影响.
    목적 탐색일충감측전순배로내동맥류술중재류동맥림시조단후피질결혈적간단、유효적방법.방법 2008년4-11월기간,대접수개로수술치료적52례전순배동맥류환자(58개동맥류)동시진행술중피질뇌전도화두피뇌전도림측.근거국제10/20계통장두피전겁치우O1、02、P3、P4、15화T6,용우감측마취심도변화;조형피질전겁치우술중가능조단동맥적공혈피질표면,용우감측정능적피질결혈.대림시조단재류동맥후피질뇌전도출현억제자여두피뇌전도변화진행비교,술후관찰유무조단혈관상응공혈구적결혈사건.결과 재58개동맥류중,유40개동맥류화41조주요동맥재술중채취료림시조단,18례환자적19조혈관림시조단후,피질뇌전도유명현변화,이두피뇌전도무명현변화.술후부재피질뇌전도명현변화조출현조단혈관상응공혈구적결혈사건9례.마취심도개변대피질화두피뇌전도영향일치.결론 동시감측피질화두피뇌전도시감측전순배로내동맥류술중피질결명적일충간단、유효적방법,병가유효변별마취대뇌전도적영향.
    Objective To develop a simple and effective method for monitoring cortical ischemia after temporary occlusion of the parent arteries during anterior circulation intracranial aneurysm surgery. Methods Fifty-two patients with anterior circulation aneurysm (58 aneurysms) received craniotomy from April to November 2008, and at the same time,cortical electroencephalograpby (EEG) and scalp EEG were monitored during the surgery.According to the international 10/20 electrode placement system, scalp electrodes were placed on O1, O2, P3, P4, T5, and T6 for monitoring the changes in the depth of anesthesia. A cortical strip electrode was placed on the cortical surface supplied by the artery that was possibly blocked during the operation, which was used to monitor the possible cortical ischemia. For patients who had cortical EEG suppression after the temporary occlusion of the parent arteries Were compared with the changes of scalp EEG. Whether there were ischemic events in the corresponding supply territory after vascular occlusion were observed after surgery. Results Of the 58 aneurysms, 40 aneurysms and 41 major arteries were occluded temporarily. After being occluded temporarily in 19 arteries of 18 patients, cortical EEG changed significantly,while scalp EEG did not change significantly. Only 9 patients had ischemic events in the corresponding supply territories after the occlusion in the cortical EEG significant change group. The changes in the depth of anesthesia had the consistent impact on cortical and scalp EEG. Conelusions Simultaneous monitoring of cortical and scalp EEG is a simple and effective method for monitoring cortical ischemia during anterior circulation intracranial aneurysm surgery, and may effectively identify the effect of anesthesia on EEG.
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