论文部分内容阅读
目的：探讨前路颈椎间盘摘除术中体感诱发电位(SSEP)监护的作用。方法2007年6月—2015年8月收治前路颈椎间盘摘除术患者150例，男98例，女52例，年龄36~76岁。神经根型颈椎病38例，脊髓型颈椎病112例。随机分为二组，监护组60例。在麻醉诱导后和摆放体位前确立 SSEP 基线，波幅降低50%或潜伏期延长>10%为报警标准。记录 SSEP 报警因素及改善措施，术后明确有无医源性神经损伤。对照组90例(无 SSEP 监护)。结果对照组无医源性神经损伤。监护组：真阳性2例出现报警，采取措施后解除报警；假阳性0例；真阴性57例 SSEP 无报警，无医源性神经损伤；假阴性1例 SSEP 无报警，术后右侧三角肌麻痹；SSEP 监护医源性神经损伤的敏感性和特异性分别为66.7%和100%。结论SSEP 在前路颈椎间盘摘除术中监护脊髓损伤方面较敏感，对神经根损伤不敏感。“,”Objective To investigate the effect of somatosensory evoked potential(SSEP)monitoring during anterior cervical spondylopathy surgery.Methods From June 2007 to August 2015,150 patients of cervical spondylopathy,98 males and 52 females,were given anterior surgery.The cases included cervical spondy-lotic radiculopathy in 38 cases,cervical spondylotic myelopathy in 112 cases.There were 90 patients in the control group without intraoperative SSEP monitoring,60 patients in the monitored group.All patients were recorded the baseline before patient positioning and after induction of anesthesia.A persistent 50%reduction in primary somatosensory cortical amplitude or a prolongation of response latency by >10% from baseline was considered to be alarm criteria.The warning and related factors and interventions were record.Identify if anyone had iatrogenic nerve injury after anesthesia.Results There was no postoperative neuro-logical deficit in the control group,but there were 2 true positives,0 false positive,57 true positives and 1 false negative in monitoring group.The sensitivity and specificity of intraoperative SSEP monitoring for de-tecting neurologic injury were 66.7% and 100%.Conclusion SSEP monitoring is sensitive for spinal cord injury,but not for nerve root injury during cervical spondylopathy surgery.