脊髓损伤皮层体感诱发电位（CSEP）术中监护的实验研究

目的：通过开展皮层体感诱发电位（ＣＳＥＰ）术中监护脊髓损伤的实验研究，以确定脊髓损伤的临界值并有效的评价预后，为临床应用提供依据。方法：２８只中国家犬随机分成４组，用ＡｌｅｎＷＤ法致脊髓轻度、重度和完全性损伤，术中ＣＳＥＰ动态监测，并观察伤后１～３个月脊髓组织学改变、ＣＳＥＰ和功能恢复情况。结果：脊髓损伤ＣＳＥＰ术中监护临界值为，伤后２分钟Ｐ１潜伏期较术前延长不超过１．５倍，波幅下降不超过５０％；伤后１０分钟Ｐ１潜伏期较术前延长不超过１．８倍，波幅下降不得超过５５％。波幅变化灵敏，其恢复早于形态学及功能变化。结论：ＣＳＥＰ术中监护脊髓损伤较准确可靠，并能评价其预后。

Experimental Study on CSEP Monitoring Spinal Cord Injury in Operation

Purpose: In order to definite the critical limits of spinal cord injury and evaluate the prognosis, the experimental study of cortical somatosensory evoked potential (CSEP) monitoring spinal cord injury in operation was carried out. To provide scientific basis for clinical application. Methods: 28 Chinese dogs were randomly divided into four groups. The mild, severe and complete spinal cord injury models were caused by Allen WD method. The spinal cord was monitored by CSEP in operation and postoperative 1 to 3 months. The morphometric change and spinal cord function were observed at 1 to 3 months after operation. Results: The critical limits of CSEP intraoperative monitoring were as follows: 2 minutes after spinal cord injury, the prolonged P 1 latency should be less than 1.5 times and the declined amplitude should be less than 50% compared with that of preoperation. 10 minutes after spinal cord injury, the prolonged P 1 latency should be less than 1.8 times and the declined amplitude should be less than 55% compared with that of preoperation. The change of amplitude is sensitive and its recovery is earlier than the morphometric change and functional recovery. Conclusion: CSEP monitoring spinal cord injury in operation is accurate and reliable. It can also predicate the prognosis of the injured spinal cord.