术中电生理检测在外周神经损伤中的应用

目的 探讨电生理检测在外周神经手术中应用的临床价值。方法 对16例17条外周神经分三组行术中电生理检测，指导术中决策和判断预后，并与术前肌电图结果或核磁共振检查结果对比。结果臂丛损伤组9例，术中体感诱发电位与核磁共振对检查完全根性损伤的检出率，经，检验差异无显著性。对臂丛损伤的大体定位，术前结合体格检查、肌电图及核磁共振结果的诊断与术中电生理检测结果完全吻合。四肢外周神经损伤组5条神经，3条术前肌电图结果与术中检测完全相符，2条不符。神经肿物组3条神经，在摘除神经瘤体后，术中电生理检测提示1例好转，2例出现不同程度的神经受损改变，术后随访与术中电生理检测的提示相符。在本组所有17条神经中，共有5条神经因术中电生理检测结果而改变了手术方案。结论 外周神经术中电生理检测的准确性优于术前的肌电图检查及核磁共振检查，具有准确、简便、实时等特点，可直接指导术中手术方案的选择；对神经肿块等原因引起的神经压迫损害，术中电生理检测可评价手术疗效，判断预后。

Application of intraoperative electrophysiologic examination in peripheral nerve lesions

Objective To investigate the clinical value of intraoperative electrophysiologic examination in peripheral nerve lesions Methods The intraoperative electrophysiological examination was applied to 17 nerves of 16 inpatients during operation The results were compared with MRI and EMG Results The operative procedures of 5 of 17 nerves were changed according to the result of intraoperative electrophysiologic examination Conclusion The diagnostic accuracy rate of intraoperative electrophysiologic examination to peripheral nerve injuries is better than preoperative EMG and MRI in peripheral nerve injuries Intraoperative electrophysiologic examination help determine the prognosis of compressive peripheral nerve lesions The method are simple,exact and real time that are convenient to guiding the decision making on operation Key words] Peripheral nerve; Brachial plexus injury; Electrophysiology; Intraoperative examination