中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2011年
4期
373-376
,共4页
肖玉强%王玉春%孙希明%彭玲波%唐海涛%陈岩%付振宇
肖玉彊%王玉春%孫希明%彭玲波%唐海濤%陳巖%付振宇
초옥강%왕옥춘%손희명%팽령파%당해도%진암%부진우
颅内动脉瘤%神经电生理%介入治疗%监测
顱內動脈瘤%神經電生理%介入治療%鑑測
로내동맥류%신경전생리%개입치료%감측
Intracranial aneurysm%Neuroelectrophysiology%Interventional therapy%Monitoring
目的 探讨神经电生理技术在颅内动脉瘤介入治疗中的应用价值.方法 对22例颅内动脉瘤患者在介入治疗过程中实施术中神经电生理监测,在术中按动脉瘤部位监测体感诱发电位(SSEP)、脑干听觉诱发电位(BAEP)、视觉诱发电位(VEP),观察术中监测的变化对颅内动脉瘤介入治疗的指导作用.结果 术后恢复良好20例,短暂性偏瘫1例,永久性偏瘫1例,其中SSEP变化8例,BAEP变化1例,VEP变化1例.其中8例在神经电生理监测下发现不同原因导致的脑组织缺血,及时采取相应措施,避免严重医源性神经功能损伤；2例在神经电生理监测指导下改变治疗方案,降低原治疗方案风险；1例通过术中神经电生理监测对患者条件进行重新评估,避免了放弃介入治疗方案,使介入治疗取得成功.结论 神经电生理监测对颅内动脉瘤介入治疗有显著的指导意义,具有重要的应用价值.可最大限度地减少动脉瘤介入治疗过程中的缺血性并发症,提高手术的安全性.
目的 探討神經電生理技術在顱內動脈瘤介入治療中的應用價值.方法 對22例顱內動脈瘤患者在介入治療過程中實施術中神經電生理鑑測,在術中按動脈瘤部位鑑測體感誘髮電位(SSEP)、腦榦聽覺誘髮電位(BAEP)、視覺誘髮電位(VEP),觀察術中鑑測的變化對顱內動脈瘤介入治療的指導作用.結果 術後恢複良好20例,短暫性偏癱1例,永久性偏癱1例,其中SSEP變化8例,BAEP變化1例,VEP變化1例.其中8例在神經電生理鑑測下髮現不同原因導緻的腦組織缺血,及時採取相應措施,避免嚴重醫源性神經功能損傷；2例在神經電生理鑑測指導下改變治療方案,降低原治療方案風險；1例通過術中神經電生理鑑測對患者條件進行重新評估,避免瞭放棄介入治療方案,使介入治療取得成功.結論 神經電生理鑑測對顱內動脈瘤介入治療有顯著的指導意義,具有重要的應用價值.可最大限度地減少動脈瘤介入治療過程中的缺血性併髮癥,提高手術的安全性.
목적 탐토신경전생리기술재로내동맥류개입치료중적응용개치.방법 대22례로내동맥류환자재개입치료과정중실시술중신경전생리감측,재술중안동맥류부위감측체감유발전위(SSEP)、뇌간은각유발전위(BAEP)、시각유발전위(VEP),관찰술중감측적변화대로내동맥류개입치료적지도작용.결과 술후회복량호20례,단잠성편탄1례,영구성편탄1례,기중SSEP변화8례,BAEP변화1례,VEP변화1례.기중8례재신경전생리감측하발현불동원인도치적뇌조직결혈,급시채취상응조시,피면엄중의원성신경공능손상；2례재신경전생리감측지도하개변치료방안,강저원치료방안풍험；1례통과술중신경전생리감측대환자조건진행중신평고,피면료방기개입치료방안,사개입치료취득성공.결론 신경전생리감측대로내동맥류개입치료유현저적지도의의,구유중요적응용개치.가최대한도지감소동맥류개입치료과정중적결혈성병발증,제고수술적안전성.
Objective To study the application of neuroelectrophysiological monitoring for interventional therapy of intracranial aneurysms.Methods 22 patients with intracranial aneurysm were received neuroelectrophysiological monitoring during interventional therapy.Somatosensory evoked potential (SSEP)、brainstem auditory evoked potential (BAEP) and visual evoked potential(VEP) were monitored during operation according to the position of intracranial aneurysm.Results 20 patients recovered well after operation.Temporary and hemiplegia were observed in 1 patient respectively.SSEP changes were observed in 8 patients,BAEP change in 1,and VEP change in 1.Cerebral ischemia was detected in 8 patients by neuroelectrophysiological monitoring and patients were given adequate management immediately.The therapeutic schedule of 2 patients were changed during neuroelectrophysiological monitoring in order to decrease the risk.1 patient was evaluated again during neuroelectrophysiological monitoring so that the original interventional therapy schedule was not given up.Conclusion Neuroelectrophysiological monitoring is significantly important during interventional therapy of intracranial aneurysm,which could reduce the risk of cerebral ischemia and enhance treatment security.
