天津医药 ›› 2017, Vol. 45 ›› Issue (8): 841-845.doi: 10.11958/20170659

• 专题 颅脑神经创伤 • 上一篇    下一篇

神经电生理监测在脊髓损伤手术中的应用进展

边科砜, 张赛, 赵永青△   

  1. 武警后勤学院附属医院脑科中心 (邮编 300162)
  • 收稿日期:2017-06-09 修回日期:2017-07-19 出版日期:2017-08-15 发布日期:2017-08-15
  • 通讯作者: △通讯作者 E-mail:605993525@qq.com E-mail:zhangsai718@vip.126.com
  • 作者简介:边科砜 (1995), 男, 本科, 主要从事临床医学及神经医学研究

Advances in the application of neurophysiological monitoring in spinal cord injury

BIAN Ke-feng, ZHANG Sai, ZHAO Yong-qing△   

  1. The Brain Center of the Affiliated Hospital of Logistics College of Chinese People’ s Armed Police Force, Tianjin 300162, China
  • Received:2017-06-09 Revised:2017-07-19 Published:2017-08-15 Online:2017-08-15
  • Contact: △Corresponding Author E-mail:605993525@qq.com E-mail:zhangsai718@vip.126.com

摘要: 近几十年来, 神经外科学的发展已经从传统的解剖学模式转变为现代解剖-功能模式, 在尽可能切除病灶 的同时最大限度地保护神经功能。神经电生理监测特别是体感诱发电位 (SEPs) 和运动诱发电位 (MEPs) 可以直接反 映神经系统感觉和运动传导通路的完整性, 目前已被广泛应用于神经外科、 脊髓脊柱外科、 血管外科等手术领域。 近年来临床外科涉及脊髓的手术越来越多, 术中神经电生理监测可以及时发现手术过程中各种原因(如机械性牵 拉、 缺血、 麻醉等) 引起的脊髓可逆性损伤, 不仅提高了手术质量, 减少了手术可能造成的医源性脊髓损伤, 而且极大 程度地改善患者预后, 减少了术后神经功能障碍及并发症。本文对神经电生理在脊髓手术中监测技术的研究动态 作一综述。

关键词: 脊髓损伤, 诱发电位, 运动, 诱发电位, 躯体感觉, 神经电生理, 肌电图, 中监测, 综述

Abstract: In recent decades, the development of the neurosurgery has changed from the traditional anatomical model to the modern anatomical- functional model. The nerve functions are maximally protected while lesions are removed as far as possible. Neurophysiological monitoring especially somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) can directly reflect the integrity of the sensory and motor nerve conduction pathways of the nervous system. At present, it has been widely used in the neurosurgery, spinal surgery, vascular surgery and other surgical fields. In recent years, more and more clinical surgeries involved spinal surgery, intraoperative neurophysiological monitoring could timely find any reversible spinal cord damage such as mechanical stretch, ischemia, and anesthetic drugs, which not only improve the quality of surgery, reduce iatrogenic spinal cord injury, but also greatly improve the prognosis of patients and reduce postoperative neurological dysfunction and complications. In this paper, the research progress of neural electrophysiological monitoring techniques in spinal cord surgery is reviewed.

Key words: spinal cord injuries, evoked potentials, motor, evoked potentials, somatosensory, neuro electrophysiology, electromyography, intraoperative monitoring, review