神经电生理监测在三叉神经痛微血管减压术中应用价值

目的探讨三叉神经痛微血管减压术(MVD)术中联合应用电生理监测技术的优越性。方法将58例采用MVD治疗的三叉神经痛病人随机分为实验组(n=30)和对照组(n=28)。实验组术中使用三叉神经诱发电位(TSEP)、脑干听觉诱发电位(BAEP)及自发性肌电图(EMG),对照组术中未使用电生理监测技术。对比分析两组手术有效率(三叉神经痛症状缓解或消失)及面瘫、听力下降等并发症的发生率。结果实验组有效率93.3%(28例),术后发生眩晕1例(3.3%),听力下降1例(3.3%),无面瘫发生。对照组术后有效率67.9%(19例),术后发生眩晕8例(28.6%),听力下降9例(32.1%),面瘫6例(21.4%)。两组手术治疗有效率及并发症发生率差异均有统计学意义(P0.05)。结论三叉神经痛MVD术中应用神经电生理技术跟踪手术进程,能较好控制并发症的发生,及时判断三叉神经减压效果。

Applied value of neurophysiological monitoring in microvascula decompression for trigeminal neuralgia

Objective To explore the superiority of microvascular decompression （MVD） combined with neurophysiological monitoring for trigeminal neuralgia.Methods Fifty-eight patients undergoing MVD for trigeminal neuralgia were divided into experimental group （n=30） and control group （n=28） at random.Experimental group received neurophysiological monitoring as trigeminal somatosensory evoked potential,brainstem auditory evoked potential,and spontaneous EMG;while control group had no intraoperative neurophysiological monitoring.The surgical success rate and complications such as,facial paralysis,hearing loss of two groups were statistically compared.Results After the surgery,the surgical success rate was 92.3% （28 cases） and 67.9% （19 cases） in experimental group and control group,respectively.In experimental group,vertigo occurred in 1 case （3.3%）,and hearing impairment in 1 case （3.3%）.In control group,vertigo occurred in 8 cases （28.6%）,hearing impairment in 9 cases （32.1%）,and facial paralysis in 6 cases （21.4%）.There were statistical differences in surgical success rate and complication rate between experimental group and control group （P0.05）.Conclusions During MVD for trigeminal neuralgia,intraoperative neurophysiological monitoring is helpful to control the complications and evaluate the efficacy of trigeminal decompression.