体感诱发电位用于脊柱手术中脊髓功能的监测

目的评估体感诱发电位(SEP)用于脊柱手术中脊髓监测的可行性，以及皮质体感诱发电位(CSEP)与皮质下体感诱发电位(Sub—CSEP)监测的适应证。方法42例脊柱手术患者，年龄6～68岁，咪唑安定、丙泊酚及维库溴铵静脉诱导，安氟醚吸入维持麻醉．术中均应用CSEP和Sub—CSEP监测脊髓功能。结果CSEP受麻醉影响较大，Sub—CSEP波形稳定，全组7例诱发电位出现异常，其中3例与临床相符，4例为假阳性，无假阴性发生，准确率为90．5％。结论CSEP适于麻醉深度的监测，Sub—CSEP是脊柱手术中脊髓功能监测较为理想的方法。

Monitoring of function of the spinal cord with somatosensory evoked potentials during spinal column surgery

Objective To evaluate the effectiveness,safety and accuracy of somatosensory evoked potential(SEP)monitoring in spinal column surgery.Methods Forty two patients,aged between 6-68 years undergoing spine operations were anesthetized with midazolam,propofol,vecuronium and enflurane and monitored by cortical somatosensory evoked potential (CSEP) and subcortical somatosensory evoked potential (Sub-CSEP).Results The affect of anesthetic agents on CSEP was greater than that of Sub-CSEP.Abnormal findings in Sub-CSEP were seen in 7cases.The changes were coordinatied with the clinical manifestations the in 3 of cases,and false positive result were found in 4 of them.The accuracy of Sub-CSEP was 90.5%. Conclusion CSEP is suitable for monitoring the depth of anesthesia ,and Sub-CSEP is an ideal method to monitor the spinal cord function in spine surgery.