CAJ | 학술논문

目的通过术中应用神经电生理监测治疗合并血管痉挛或狭窄的颅内动脉瘤来讨论术中应用的意义.方法本次研究对28例患者在术中应用神经电生理监测技术时出现波形变化,并对神经介入治疗颅内动脉瘤的术中患者电生理变化做出正确的判断,做出及时调整,如扩容、提高血压、解痉甚至暂时停止手术进程等措施,使术者顺利完成颅内动脉瘤的治疗,将手术并发症减至最小.结果 28例患者中术前有10例狭窄,18例血管痉挛.术中由于载瘤动脉狭窄,有4例患者神经电生理波形出现明显下降,在18例血管痉挛的患者中,有14例出现波形下降50％,给予及时扩容、提高血压、解痉甚至暂时停止手术进程等措施,所有患者的神经电生理波形均恢复正常.术后3例患者遗留神经功能缺损,随访72 h后均恢复正常.结论在颅内动脉瘤神经介入治疗中应用神经电生理监测,可以大大减少术后并发症的发生,可以提高手术的成功率.
목적 통과술중응용신경전생리감측치료합병혈관경련혹협착적로내동맥류래토론술중응용적의의.방법 본차연구대28례환자재술중응용신경전생리감측기술시출현파형변화,병대신경개입치료로내동맥류적술중환자전생리변화주출정학적판단,주출급시조정,여확용、제고혈압、해경심지잠시정지수술진정등조시,사술자순리완성로내동맥류적치료,장수술병발증감지최소.결과 28례환자중술전유10례협착,18례혈관경련.술중유우재류동맥협착,유4례환자신경전생리파형출현명현하강,재18례혈관경련적환자중,유14례출현파형하강50％,급여급시확용、제고혈압、해경심지잠시정지수술진정등조시,소유환자적신경전생리파형균회복정상.술후3례환자유류신경공능결손,수방72 h후균회복정상.결론 재로내동맥류신경개입치료중응용신경전생리감측,가이대대감소술후병발증적발생,가이제고수술적성공솔.
Objective To study the significance of the application of intraoperative neurophysiological monitoring in the endovascular treatment for intracranial aneuryms with vasospasm or stenosis.Methods Intraoperative neurophysiological monitoring was performed during the endovascular treatment for 28 patients of intracranial aneuryms with vasospasm or stenosis.The in-time adjustments,such as capacity enlargement,blood pressure increasing,spasmolysis or even stopping the procedure,were performed according to the neurophysiological variation of the patients so as to make the endovascular procedure successfully and reduce the post-operative complications.Results There were 10 patients of stenosis and 18 patients of vasospasm.The neurophysiological waves were obviously reduced in 4 patients with parental artery stenosis,and reduced for 50％ in 14 patients out of 18 patients with vasospasm.After appropriate management,the neurophysiological waves of all the patients were recovered to the normal conditions.There were 3 patients with hemiplegia after the operation,and they recovered after 72 hours.Conclusions The application of the intraoperative neurophysiological monitoring during the neurointervention treatment of intracranial aneuryms could reduce the post-operative complications greatly and increase the successful rate of the operation.