多模式神经电生理检测对脊髓手术患者神经功能状态的评估分析及其影响因素

 目的 使用肌电图(electromyography,EMG)、体感诱发电位(somatosensory evoked potential,SEP)与运动诱发电位(motor evoked potentials,MEP)多模式方法检测手术前后神经系统的多种电生理信号,探讨患者神经功能状态。方法 收集100例患者作为研究对象,术中监测患者双下肢的SEP与MEP情况;术后6个月复查患者EMG。结果 术中SEP波幅与潜伏期在较稳定情况下,MEP监测中42例患者术中的D波波幅发生降低未超过50%,22例患者出现D波波幅突然下降且超过50%。Pearson相关性分析结果表明,术中出血量与SEP及MEP波幅与潜伏期的改变具有相关性。术后复查,各组患者的腓总神经与胫神经的NCV与DL均有显著改善,异常组患者的改善情况明显低于其他四组。结论 使用EMG、SEP与MEP多模式神经电生理检测可以去除干扰因素,为脊髓手术提供客观、有价值的诊疗依据。

Evaluation of neurologic function and influencing factors in patients with spinal cord surgery

Objective To investigate the various electrophysiological signals of the nervous system before and after operation using EMG, SEP and MEP multimode methods, and to explore the neurofunctional status of patients.Methods One hundred patients were collected as subjects, and the SEP and MEP of patients with bilateral lower limbs were monitored. EMG was resumed 6 months after surgery.Results The SEP amplitude and latent period were stable during the operation. In the process of MEP monitoring, the amplitude of D wave was decreased by less than than 50% in 42 patients, but suddenly decreased by more than 50% in 22 patients. Pearson correlation analysis showed that intraoperative blood loss was associated with changes in SEP and MEP amplitude and latency.The postoperative re-examination found that the NCV and DL of the peroneal nerve and tibial nerve in each group were significantly improved, but the abnormal group improved much less significantly than in the other four groups.Conclusions EMG,SEP and MEP multimode neuroelectrophy-siological detection can remove interference and provide Objective and valuable data for diagnosis and treatment of spinal cord surgery.