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目的:分析生长棒撑开术中经颅刺激运动诱发电位(MEP)和体感诱发电位(SEP)神经功能监测的应用价值。方法:回顾性分析2010年10月~2015年1月我院进行的65例141次生长棒撑开手术,在生长棒撑开术中,运用MEP和SEP进行神经功能监测。MEP监测采用经颅刺激C3、C4,记录外周肌源性MEP,SEP监测采用刺激双侧胫后神经,记录电极采用Cz-CPz。阳性诊断标准:与基线相比,MEP波幅下降75%,SEP波幅下降50%或潜伏期延长10%。结果:141例次撑开手术中成功获得具有监护价值且重复性较好MEP 139例次,检出率98.6%,全程失败2例次(占1.4%);SEP成功监测140例次,检出率99.3%,失败1例(占0.7%)。所有患者均能成功记录到一种以上的诱发电位。本组141例次手术中未出现MEP及SEP监测阳性。所有患儿术后神经系统检查均无异常发现,神经功能监测结果均为真阴性。结论:生长棒撑开术是简单安全的手术操作,但是,运用MEP和SEP进行术中神经功能监测可以为生长棒撑开术提供客观的安全评估指标。
Objective: To evaluate the value of monitoring transcranial motor evoked potentials (MEP) and somatosensory evoked potentials (SEP) in the monitoring of growth-distraction. Methods: A retrospective analysis of 141 cases of 141 rods performed in our hospital from October 2010 to January 2015 was performed. MES and SEP were used to monitor the neurological function during the growth of the rods. MEP monitoring using transcranial C3, C4, recording peripheral muscular MEP, SEP monitoring using stimulation of bilateral posterior tibial nerve, recording electrode Cz-CPz. Positive diagnostic criteria: MEP amplitude decreased 75%, SEP amplitude decreased 50% or latency 10% compared with baseline. Results: In 141 cases of submandibular open operation, 139 cases were successfully treated with MEP, with a good repeatability, with a detection rate of 98.6% and a complete failure of 2 cases (1.4%). SEP was successfully monitored for 140 cases and was detected Rate of 99.3%, failed in 1 case (0.7%). All patients successfully recorded more than one evoked potentials. 141 cases of this group did not appear in the MEP and SEP positive. All children with postoperative neurological examination showed no abnormal findings, neurological monitoring results are true negative. CONCLUSION: Growth bar brace is a simple and safe surgical procedure. However, the use of MEP and SEP for intraoperative nerve function monitoring can provide an objective safety assessment index for growth bar brace.