脑干听觉诱发电位在听阈正常的语言发育迟缓患儿中的意义

目的 探讨脑干听觉诱发电位（BAEP）在听阈正常而语言发育迟缓患儿中的变化规律及应用价值.方法 分析100例听阈正常而语言发育迟缓患儿BAEP的变化规律;按年龄分组比较两个年龄段之间各波的延长时间.结果 （1）BAEP正常10例,异常90例,BAEP表现为Ⅰ、Ⅴ波潜伏期（PL）延长,Ⅲ~Ⅴ、Ⅰ~Ⅴ波峰间期（IPL）延长;（2）随着年龄增长,Ⅴ波PL与Ⅲ~Ⅴ波IPL延长时间越长.结论 Ⅰ波、Ⅴ波延长对早期诊断听阈正常而语言发育迟缓患儿具有一定的意义,说明即使听阈正常也可能存在听觉传导通路异常,且随着年龄增加,脑干上段受损越严重.     

前庭阵发症脑干听觉诱发电位的特点

目的探讨前庭阵发症(VP)脑干听觉诱发电位(BAEP)的特点。方法对51例VP患者的BAEP结果进行回顾性分析。结果 BAEP异常者40例,异常率为78.4%。与Ⅰ-Ⅲ波峰间期正常的患者相比,Ⅰ-Ⅲ波峰间期延长的患者男性比例高(χ2=4.763,P=0.029),病程显著延长(t=2.469,P=0.021),而平均年龄差异无统计学意义。与Ⅲ-Ⅴ波峰间期正常的患者比较,Ⅲ-Ⅴ波峰间期延长的患者男性比例、平均病程、平均年龄差异均无统计学意义。与Ⅰ-Ⅲ波峰间期耳间差正常的患者比较,Ⅰ-Ⅲ波峰间期耳间差延长的患者病程相对较长(P=0.055),男性有增多趋势(P=0.058),但差异无统计学意义。结论 VP患者BAEP异常以Ⅰ-Ⅲ波峰间期延长为主,且以男性更多见。病程越长,蜗神经越易受累。     

59例听神经瘤患者脑干听觉诱发电位分析

目的 分析听神经瘤(acoustic neuroma,AN)患者的脑干听觉诱发电位的变化特征及健侧耳峰间期改变.方法 对59例听神经瘤(AN)患者进行脑干听觉诱发电位(BAEP)检测,测定Ⅰ、Ⅲ、Ⅴ波潜伏期(PL)、峰间期(IPL),双耳PL、IPL之间差值(ILD)等数值.结合MRI、CT影象学资料进行分析,并与36例健康者对照.结果 AN组与正常对照组BAEP各波PL、IPL测值比较差异有极显著性(P＜0.01).AN患侧BAEP异常率98.3%(58/59);主要表现:①Ⅰ、Ⅲ、Ⅴ波缺失;②Ⅲ、Ⅴ波PL延长;③Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波IPL延长.AN患者健侧BAEP的异常率69.5%(41/59),主要表现:①Ⅴ波PL延长;②Ⅲ～Ⅴ及Ⅰ～Ⅴ波IPL延长;③Ⅲ～Ⅴ/Ⅰ～Ⅲ波IPL比值＞1.肿瘤直径＞2cm,BAEP的异常率有显著提高.不同大小肿瘤组间健侧BAEP测值比较:健侧Ⅴ波PL差异有显著性(P＜0.05),Ⅲ～Ⅴ及Ⅰ～ⅤIPL差异有极显著性(P＜0.01).结论 BAEP对AN诊断具有重要意义,它为病变提供了定位诊断依据,尤其健侧Ⅲ～Ⅴ/Ⅰ～Ⅲ波IPL比值异常,是脑干受压的敏感指标.     

飞机噪声职业暴露人群脑干听觉诱发电位测定研究

目的 研究脑干听觉诱发电位作为飞机噪声听力影响测试指标的可行性。方法 (1)用意大利产VAGA—10型电生理仪对60名飞机维修保养人员及120名对照人群进行脑干听觉诱发电位(Brainstem Auditory Evoked Potentials,BAEP)测试。(2)根据统计分析研究脑干听觉诱发电位作为飞机噪声引起的听力损害的早期检测指标的可行性及相关职业因素对脑干听觉诱发电位的影响。结果(1)飞机噪声职业接触人群脑干听觉诱发电位Ⅰ、Ⅲ、Ⅴ波的潜伏期值及Ⅰ～Ⅴ波的峰间潜伏期值与对照组有显著性差异,P<0.05;左耳Ⅰ-Ⅲ波、右耳Ⅲ—Ⅴ波的峰间潜伏期值两组比较也有显著性差别,P<0.05。(2)脑干听觉诱发电位数据多因素方差分析表明BAEP各波的潜伏期值与工龄、职业接触飞机噪声、接触噪声强度、日接触时间等因素均有关。年龄、工龄等因素对职业接触高强度飞机噪声产生的听力影响有增效作用。结论 BAEP潜伏期值可预测飞机噪声对听力的早期影响,BAEP测试方法可作为飞机噪声职业危害的早期敏感性检测指标。     

大鼠头颅侧向旋转脑损伤模型脑干听觉诱发电位的变化

目的探讨头颅侧向旋转致脑损伤大鼠模型脑干听觉诱发电位（BAEP）的变化及机制。方法成年大鼠20只，制作头颅瞬间侧向旋转脑损伤模型，测量头颅旋转前及旋转后6h的BAEP，测量电极置于颅顶左侧c2点，左耳予短暂click声刺激，右耳持续予噪声掩蔽，经1000次叠加平均，记录BAEP各波形的潜伏期、波间期和波幅值。结果大鼠头颅旋转后6h和Ⅴ波潜伏期、Ⅰ～Ⅲ和Ⅲ～Ⅴ波波间期明显较旋转前延长，Ⅰ和Ⅴ波波幅较旋转前明显降低，而旋转前后Ⅰ波潜伏期、Ⅰ～Ⅴ波波间期以及Ⅰ波波幅无显著差异。结论头颅瞬间侧向旋转可引起BAEP异常，此与脑干内特殊传导通路的破坏有关，其结构基础为脑干广泛神经轴索损伤。     

面肌痉挛显微血管减压术中脑干听觉诱发电位监测的应用

目的 研究脑干听觉诱发电位(BAEP)监测在显微血管减压术(MVD)治疗面肌痉挛手术中的应用.方法 回顾性分析90例面肌痉挛患者在MVD术中进行BAEP监测的临床资料.结果 MVD手术操作过程均可引起BAEP改变,包括:BAEP的Ⅰ、Ⅲ、Ⅴ波绝对潜伏期明显延长(P＜0.01),Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波间期明显延长(P＜0.01),Ⅲ波、Ⅴ波波幅明显降低(P＜0.01);有16例术中Ⅴ波绝对潜伏期延长超过1ms,Ⅰ波波幅也有明显降低(P＜0.01),但术后无听力障碍;手术结束时Ⅲ～Ⅴ波间期及16例的Ⅰ、Ⅴ波波幅恢复较快.2例术后患侧听力丧失的患者中,1例术中Ⅴ波波幅逐渐降低至消失,另1例术中未监测到Ⅴ波波形.结论 MVD手术操作过程均可引起BAEP改变;Ⅴ波绝对潜伏期延迟超过1ms者相对多见,但无听力受损;Ⅴ波波幅下降程度可为术中神经功能受损提供客观指标,以采取相应措施减少听力并发症的发生.     

慢性肾功能衰竭患者血液透析前后脑干听觉诱发电位分析

目的 观察慢性肾功能衰竭患者血液透析前后脑干听觉诱发电位(BAEP)的变化。方法 对30例慢性肾功能衰竭患 者血液透析前及平均透析5个月后分别行BAEP测定。结果 30例慢性肾功能衰竭患者BAEP异常率为83.3％,主要表现为Ⅰ、Ⅲ、 Ⅴ主波潜伏期(PLs)延长及Ⅰ-Ⅲ、Ⅰ-Ⅴ峰间潜伏期(IPLs)延长;平均透析5个月,患者透析前后比较,透析后Ⅲ、Ⅴ PLs和Ⅰ-Ⅲ、 Ⅰ-Ⅴ IPLs缩短有显著性意义。结论 BAEP的测定及动态观察是慢性肾功能衰竭时听觉神经系统损害的客观指标。     

慢性肾功能衰竭患者血液透析前后脑干听觉诱发电位分析

目的观察慢性肾功能衰竭患者血液透析前后脑干听觉诱发电位(BAEP)的变化。方法对30例慢性肾功能衰竭患者血液透析前及平均透析5个月后分别行BAEP测定。结果30例慢性肾功能衰竭患者BAEP异常率为83．3％，主要表现为Ⅰ、Ⅲ、Ⅴ主波潜伏期(PLa)延长及Ⅰ-Ⅲ、Ⅰ-Ⅴ峰间潜伏期(IPLs)延长；平均透析5个月，患者透析前后比较，透析后Ⅲ、VPLs和Ⅰ-Ⅲ、Ⅰ-ⅤIPLs缩短有显著性意义。结论BAEP的测定及动态观察是慢性肾功能衰竭时听觉神经系统损害的客观指标。     

后循环梗死患者的BAEP、BR、TSEP检测

目的:探讨后循环脑梗死(PCI)患者脑干听觉诱发电位(BAEP)、瞬目反射(BR)、三叉神经诱发电位(TSEP)三种电生理变化.方法:选择60例经头颅MRI检查证实为PCI患者(病例组),分别于人院一周之内行BAEP、BR、TSEP检查,观察BAEP波形及Ⅰ、Ⅲ、Ⅴ波潜伏期(PL)、峰间期(IPL),计算BR的R1、R2、R2′波平均PL、波幅及TSEP各成分PL,并与40例健康体检者作对照.结果:病例组60例中BAEP异常35例(58%),异常主要表现为Ⅰ、Ⅴ波的PL、Ⅰ-Ⅴ波的IPL延长和Ⅰ/Ⅴ波幅比＞1.BR异常33例(55%),异常主要表现为R2波的PL延长,R2、R2′波幅下降.TSEP检查病例组与对照组PL比较未见明显差异.结论:BAEP、BR两种电生理检查方法能够较好地检测出PCI患者神经功能异常,联合应用BAEP及BR能够为PCI患者的神经功能的判断提供重要参考.     

脑创伤后长期意识障碍患者脑干听觉诱发电位表现与预后清醒的关系

目的 探讨重型创伤性颅脑损伤(TBI)后长期意识障碍患者脑干听觉诱发电位(BAEP)表现与预后清醒的关系.方法 分析63例重型TBI后意识障碍超过2周患者的BAEP表现,主要为BAEP中Ⅰ、Ⅲ、Ⅴ波各波峰潜伏期(PL),Ⅰ～Ⅲ、Ⅲ～Ⅴ波峰间潜伏期(IPL)及Ⅰ波与Ⅴ波波幅比.预后以TBI后6个月患者是否清醒为标准,分为清醒组与未清醒组,组间运用两独立样本t检验以筛选出有意义的指标.结果 本组患者清醒率为34.9%(22/63),BAEP指标异常率为66.7%(42/63).双侧Ⅰ、Ⅲ、Ⅴ波PL,Ⅰ～Ⅲ波、Ⅲ～Ⅴ波IPL及Ⅰ/Ⅴ波幅比均正常的21例中有16例清醒(清醒率为76.2%),双侧Ⅴ波PL异常的8例及双侧Ⅲ～Ⅴ波IPL异常的7例均未清醒,单侧Ⅴ波消失的2例未清醒.清醒组与未清醒组间比较发现双侧差异均有统计学意义的指标为Ⅴ波PL及Ⅲ～Ⅴ波IPL.结论 BAEP的Ⅴ波PL及Ⅲ～Ⅴ波IPL变化可客观、准确地反映脑损伤的程度及预测患者的预后.

Abstract：

Objective To explore the correlation between brainstem auditory evoked potential (BAEP) findings and outcome in long-term unconscious patients with severe traumatic brain injury (TBI).Methods BAEP findings were recorded and analyzed in 63 patients suffering from severe TBI with duration of disturbance of unconsciousness for more than 2 weeks. The peak latency (PL) of wave Ⅰ, Ⅲ and Ⅴ, the interpeak latency (IPL) of wave Ⅰ-Ⅲ and Ⅲ-Ⅴ and the amplitude ratio of wave Ⅰ and Ⅴ were analyzed. Conscious or unconscious at 6 months after the injury was considered as the outcome criterion,and based on these, the patients were divided into conscious and unconscious groups; the significant indicators were chosen in the 2 groups using independent-sample t test. Results The probabilities of awakening in these patients were 34.9% (22/63) with abnormal index of BAEP indicators reaching 66.7%. Sixteen patients were sober at last in 21 patients with normal PL of wave Ⅰ, Ⅲ and Ⅴ, IPL of wave Ⅰ-Ⅲ and Ⅲ-Ⅴ, and amplitude ratio of wave Ⅰ and Ⅴ in bilateral side (the probabilities of awakening were 76.2%); 8 patients having abnormal PL of wave Ⅴ in bilateral side and 7 having abnormal IPL of wave Ⅲ-Ⅴ in bilateral side were unconscious; 2 patients having disappeared wave Ⅴ in unilateral side were unconscious. PL of wave Ⅴ and IPL of wave Ⅲ-Ⅴ in bilateral side were significantly different between the conscious group and the unconscious group. (P＜0.05). Conclusion BAEP findings (PL of wave Ⅴ and IPL of wave Ⅲ-Ⅴ in bilateral side) can objectively and accurately demonstrate the cerebral dysfunction and predict the outcome of the patients.     

脑干听觉诱发电位分级对脑创伤长期意识障碍患者清醒预测的价值

目的 探讨脑干听觉诱发电位(BAEP)分级标准对脑创伤后长期意识障碍患者清醒预测的价值.方法 分析93例脑创伤后长期意识障碍患者的BAEP表现,将BAEP分为3级:Ⅰ级为各波均正常;Ⅲ级为双侧V波PL异常、双侧Ⅲ～Ⅴ波IPL异常、单侧或双侧V波消失;Ⅱ级为除Ⅲ级之外的任何异常BAEP表现.以脑创伤后6个月作为判断是否清醒的时间标准.结果 Ⅰ级、Ⅱ级、Ⅲ级的清醒率分别为:79％、18％和0％.分级与清醒差异有统计学意义(r=-0.662,P＜0.001),分级越高,清醒越困难.BAEP分级标准对清醒预测的ROC曲线下面积为0.859,95％可信区间为(0.781～0.937).结论 BAEP分级能客观、准确地反映脑功能损伤程度和预测清醒的概率.     

Characteristics of brainstem auditory evoked potential of neonates with mild or moderate hyperbilirubinemia

BACKGROUND: Brainstem auditory evoked potential (BAEP) has been widely used to evaluate the functional integrity and development of injured auditory system and brain, especially to objectively evaluate the function of auditory system and brain stem of very young babies, such as neonates and sick babies. OBJECTIVE: To observe the changes of BAEP of neonates with hyperbilirubinemia, and to investigate the relationship of bilirubin concentration and BAEP. DESIGN: An observation experiment. SETTING: Department of Pediatrics, the 309 Clinical Division, General Hospital of Chinese PLA. PARTICIPANTS: Fifty-eight neonates with mild or moderate hyperbilirubinemia exhibiting jaundice within 24 hours after born, who received the treatment in the Department of Pediatrics, the 309 Clinical Division, General Hospital of Chinese PLA between January 2004 and May 2007, were recruited in this study. The involved neonates, 31 boys and 27 girls, had gestational age of 37 to 46 weeks. They had no history of birth asphyxia, and were scored 8 to 10 points when born. Written informed consents of examination and treatment were obtained from the guardians of the neonates. This study was approved by the Hospital Ethics Committee. According to serum total bilirubin value, the neonates were assigned into 3 groups: low-concentration bilirubin group (n =16), moderate-concentration bilirubin group (n =27) and high-concentration bilirubin group (n =15). According to mean daily bilirubin increase, the subjects were sub-assigned into bilirubin rapid increase group (n =39) and bilirubin slow increase group (n =19). METHODS: After admission, all the neonates received drug treatment. Meanwhile, their 116 ears were examined with a myoelectricity evoked potential equipment (KEYPOINT) in latency, wave duration, amplitude and wave shape differentiation of each wave of BAEP. BAEP abnormal type was observed and abnormal rate of BAEP was calculated. MAIN OUTCOME MEASURES: ① Abnormal rate and abnormal type of BAEP. ② Latency of waves Ⅰ, Ⅲ　and Ⅴ, and wave duration of waves Ⅰ to Ⅲ, Ⅲ to Ⅴ, and Ⅰ to Ⅴ. RESULTS: Fifty-eight neonates with mild or moderate hyperbilirubinemia were involved in the final analysis. ①Abnormal type and abnormal rate of BAEP of neonates with hyperbilirubinemia: Among the 116 ears, unilateral or bilateral waves Ⅰ, Ⅲ, Ⅴ still existed. The latency of waves Ⅰ, Ⅲ and Ⅴ was +2.5 s longer than the normal level in 8, 4 and 15 ears, respectively. The wave duration of waves Ⅰ to Ⅲ and waves Ⅲ to Ⅴ was +2.5 s longer than the normal level in 6 and 14 ears, respectively. The wave duration of waves Ⅲ to Ⅴ was longer than that of ipsilateral waves Ⅰ to Ⅲ in 24 ears. The latency difference of wave Ⅴ between two ears was larger than 0.4 ms in 31 neonates with hyperbilirubinemia; The amplitude of wave Ⅴ to that of ipsilateral wave I was lower than 0.5 in 29 neonates. Totally 52 ears were abnormal, and the abnormal rate was 44.8%. One to two months later, 98% abnormal neonates with hyperbilirubinemia recovered. The abnormal rate in the low-, moderate-, and high-concentration bilirubin groups was 37.5%, 44.4% and 53.3%, respectively. ② Comparison of latency and wave duration of each wave of BAEP: Latency of waves Ⅰ, Ⅲ and Ⅴ, and wave duration of waves Ⅰ to Ⅲ and Ⅲ to Ⅴ were gradually prolonged in low-, moderate-, and high-concentration bilirubin groups, but significant difference did not exist between two groups (P > 0.05). ③ There were no significant differences in latency of waves Ⅰ, Ⅲ and Ⅴ, and wave duration of waves Ⅰ to Ⅲ, Ⅲ to Ⅴ and Ⅰ to Ⅴ between bilirubin rapid increase group and bilirubin slow increase group (P > 0.05). CONCLUSION: Auditory acuity and brainstem of neonates with mild or moderate hyperbilirubinemia are damaged to some extent. High-concentration bilirubin causes BAEP abnormality easily. Bilirubin increase and its concentration change are not consistent with nervous lesion degree.     

脑干听觉诱发电位在后循环脑梗死中的临床应用价值研究

目的 通过分析急性和慢性后循环脑梗死患者脑干听觉诱发电位变化特点,探讨脑干听觉诱发电 位（brainstem auditory evoked potential,BAEP）在后循环脑梗死早期识别和诊断方面的临床应用价值。 方法 选择2018年8月-2019年3月在上海第六人民医院神经内科就诊的后循环脑梗死患者为研究 对象,分为急性脑梗死组和慢性脑梗死组,同时设立健康对照组。比较3组BAEP的Ⅰ、Ⅲ、Ⅴ各波峰 潜伏期（peak latency,PL）,Ⅰ～Ⅲ波、Ⅲ～Ⅴ波和Ⅰ～Ⅴ波峰间潜伏期（interpeak latency,IPL）,Ⅲ～Ⅴ波 /Ⅰ～Ⅲ波I PL的比值等指标的特点。 结果 研究共入组急性脑梗死组患者36例,慢性脑梗死组32例,健康对照组32例。急性脑梗死组 Ⅲ波、Ⅴ波PL较慢性脑梗死组（P＜0.001、P =0.005）和对照组（均为P＜0.001）均延长;慢性脑梗死组 Ⅴ波PL较对照组延长（P＜0.001）。急性脑梗死组Ⅰ～Ⅲ波、Ⅰ～Ⅴ波I PL较慢性脑梗死组延长（P＜0.001、 P =0.029）;急性脑梗死组Ⅰ～Ⅲ波（P＜0.001）、Ⅲ～Ⅴ波（P =0.006）和Ⅰ～Ⅴ波（P＜0.001）IPL较对照 组延长;慢性脑梗死组Ⅲ～Ⅴ波I PL（P =0.003）较对照组延长。慢性脑梗死组Ⅲ～Ⅴ/Ⅰ～Ⅲ波IPL比值 异常者有9例（25.0%）,急性脑梗死组2例（6.3%）,两组差异有统计学意义（P =0.001）。 结论 ①BAEP检查能灵敏地检测出急性和慢性后循环脑梗死患者的听觉感觉通路的电生理异常。 ②急性脑梗死患者BAEP的Ⅲ波和Ⅴ波PL、Ⅰ～Ⅲ波和Ⅰ～Ⅴ波IPL均显著延长,以Ⅲ波PL、Ⅰ～Ⅲ波IPL延 长为主;慢性脑梗死患者BAEP以Ⅴ波PL、Ⅲ～Ⅴ波IPL的延长为主。     

Changes of brainstem auditory and somatosensory evoked

Objective: to investigate the characteristics and clinical value of evoked potentials in late infantile form of metachromatic leukodystrophy. Methods: Brainstem auditory, and somatosensory evoked potentials were recorded in 6 patients, and compared with the results of CT scan. Results: All of the 6 patients had abnormal results of BAEP and MNSEP. The main abnormal parameters in BAEP were latency prolongation in wave I, inter-peak latency prolongation in Ⅰ-Ⅲ and Ⅰ-Ⅴ. The abnormal features of MNSEP were low amplitude and absence of wave N9, inter-Peak latency prolongation in Ng-N13 and N13-N20, but no significant change of N20 amplitude. The results also revealed that abnormal changes in BAEP and MNSEP were earlier than that in CT. Conclusion: The detection of BAEP and MNSEP in late infantile form of metachromatic leukodystrophy might early reveal the abnormality of conductive function in nervous system and might be a useful method in diagnosis.     

大鼠脑桥、中脑电损伤后脑干听觉诱发电位的敏感性研究

目的 探讨大鼠脑桥、中脑电损伤后脑干听觉诱发电位(BAEP)的敏感指标.方法 SD大鼠80只,分别于左侧脑桥面丘和中脑上下丘之间深部给予电损伤,按照电流刺激量的不同各分为小剂量组(1 mA)、中剂量组(3 mA)、高剂量组(6 mA)、对照组(0 mA),每组10只,记录和比较各组电损伤前后的BAEP各指标的变化.每组取2只行病理学检查.结果 电损伤后,脑组织均有不同程度的神经元坏死等改变,损伤程度随电流量加大而增加.脑桥小剂量组BAEP的V波的PL、Ⅲ～Ⅴ、Ⅰ～Ⅴ波IPL延长,中剂量组的Ⅲ、V波的PL、Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波IPL延长,高剂量组的Ⅲ、Ⅴ波的PL、Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波IPL延长,伴Ⅲ、Ⅴ波的波幅下降;中脑中剂量组、高剂量组V波PL延长,Ⅰ～Ⅴ、Ⅲ～Ⅴ波IPL延长,损伤前后的差值与对照组比较,有统计学意义.结论 (1)BAEP的Ⅴ波PL可能为反映脑桥和中脑损伤的敏感指标;(2)BAEP反映中脑损伤不如脑桥敏感.

Abstract：

Objective To explore the sensitive indexes of brainstem auditory evoked potentials(BAEP)in rats exposed to electric injury in the pons and the midbrains.Methods The pones and midbrains of 80 rats were electric injured beneath the left facial colliculus and quadrigeminal bodies.In the pone group or the midbrain group,the animals were further divided into 4 groups:controls(0 mA),low (1 mA),middle(3 mA)and high electric current(6 mA)respectively,according to the amount of electrical stimulation.The indexes of BAEP were recorded and analyzed before and after injury.Results It was shown that electric injury resulted in neuronal necrosis,the extent of which tended to be designated as much more severe according to the amount of electrical stimulation.In the pone groups,the peak lantency(PL)of waves Ⅴ and the interpeak lantency(IPL)of waves Ⅰ～Ⅴ,Ⅲ～Ⅴ were prolonged at low electric current. However,the PL of waves Ⅲ,Ⅴ and the IPL of waves Ⅰ～Ⅲ,Ⅲ～Ⅴ,Ⅰ～Ⅴ were prolonged at middle and high electric current,and the amplitudes of waves V were decreased at high electric current significantly compared with the controls.In the midbrain groups,the PL of waves Vand the IPL of waves Ⅲ～Ⅴ,Ⅰ～Ⅴ at middle and high electric current were prolonged significantly compared with the controls.Conclusions The peak lantency of the waves V may be the most sensitive indexes of BAEP as to the pons and midbrains injured,but the changes of BAEP is less sensitive in midbrain than in pons.     

听神经瘤患者BAEP特征和术中面听神经保留情况分析

目的 分析听神经瘤(AN)患者脑干听觉诱发电位(BAEP)特征和显微外科手术中面、听神经保留情况.方法 安徽医科大学附属省立医院神经外科自2006年5月至2009年5月共采用肿瘤切除术治疗76例AN患者,术前术中均进行BAEP检查,分析患者术前、术中BAEP异常情况及AN直径大小与和术后面、听神经保留情况的关系.结果 AN患者术前患侧BAEP异常76例(76/76,100%),健侧BAEP异常63例(63/76,82.9%),两侧比较差异有统计学意义(P<0.05);术中健侧BAEP异常70例(70/76,92.1%),与术前健侧BAEP异常率比较差异有统计学意义(P<0.05);术中健侧BAEP异常与面、听神经的保留分别呈正相关关系(r=0.912,P=0.000;r=0.613,P=0.000);而AN直径与面、听神经的保留分别呈负相关关系(r=-0.869,P=0.000;r=-0.738,P=0.000).结论 术前BAEP检测对AN病变提供诊断依据,术中进行BAEP监测可提高面听神经的保留率,且AN直径越大,面、听神经越难保留.