CAJ | 학술논문

目的探讨全静脉麻醉下运动诱发电位(MEP)联合体感诱发电位(SEP)术中监测应用于脊髓髓内肿瘤手术的优越性、可靠性及临床应用价值.方法对72例脊髓髓内肿瘤患者术中行SEP和MEP联合监测,参照McCormick评分标准对术前、术后脊髓功能的改变和诱发电位变化之间的关系进行统计分析.结果 14例脊髓神经功能改善,18例术后脊髓神经功能下降者与诱发电位监测结果具有一致性(P＜0.05).结论对脊髓髓内肿瘤手术进行SEP与MEP监测有利于避免"假阴性/假阳性"结果及术后神经功能障碍的发生.
목적 탐토전정맥마취하운동유발전위(MEP)연합체감유발전위(SEP)술중감측응용우척수수내종류수술적우월성、가고성급림상응용개치.방법 대72례척수수내종류환자술중행SEP화MEP연합감측,삼조McCormick평분표준대술전、술후척수공능적개변화유발전위변화지간적관계진행통계분석.결과 14례척수신경공능개선,18례술후척수신경공능하강자여유발전위감측결과구유일치성(P＜0.05).결론 대척수수내종류수술진행SEP여MEP감측유리우피면"가음성/가양성"결과급술후신경공능장애적발생.
Objective To investigate the reliability,superiority and value of combined monitoring of motor evoked potentials(MEP) and somatosensory evoked potentials(SEP) during intramedullary spinal cord tumor surgery under total intravenous anesthesia.Method 72 patients with intramedullary spinal cord tumor were monitored somatosensory evoked potentials and muscle motor evoked potentials during operation.McCormick scale was adopted to evaluate the patients' clinical nerve function.The postoperative to preoperative McCormick grade variation and combimed monitoring of SEP and MEP were compared in this group.Result 14 patients' nerve function was improved.The findings of monitoring were evaluated in 18 patients with depressed McCormick scores.There was significant difference in the latency and amplitude of waves between pretreatment and post-treatment (P＜0.05).The changes of SEP and MEP were correlative with the changes of spinal cord function.Conclusion Combined monitoring of SEP and MEP could help to improve postoperative McCormick scale outcome significantly for patients with intramedullary spinal cord tumor.The waveform of either SEP or MEP might be stable and reliabie in monitoring patients under total intravenous anesthesia.It might be helpful in avoiding 'false negative and/or false positive results'as well as the postoperative neurological sequelae.