术中神经电生理监测技术在儿童神经外科手术中的应用

Application of intraoperative neurophysiological monitoring during pediatric neurosurgery

术中神经电生理监测已经成为现代微侵袭神经外科治疗不可缺少的辅助技术,它通过各种电生理技术提供术中实时神经功能监测、协助判断切除范围以及减少神经功能损伤。儿童神经系统处于生长发育阶段,在疾病谱、疾病电生理特点、术中神经电生理监测参数等方面与成人不同。目前术中神经电生理监测技术在成人神经外科已普遍开展,但在儿童神经外科尚处于探索阶段,仍然存在很多问题及争议。本文结合笔者三十余年成人及儿童神经外科工作中开展神经电生理监测的经验,结合文献,阐述神经电生理监测技术在儿童神经外科手术中的应用及价值。

Intraoperative neurophysiological monitoring(IONM)has become an indispensable and important auxiliary technology during modern mini-invasive neurosurgery.It provides real-time intraoperative monitoring of nerve function through various technical means,helping to determine the scope of resection and minimize neurological damage.Pediatric nervous system stays within the stage of growth and development.Disease spectrum,electrophysiological characteristics and parameters of IONM are different from those of adults.Currently IONM in pediatric neurosurgery remains in exploratory stage and many outstanding problems and deficiencies persist.Over three-decade experiences of IONM were summarized during adult and pediatric neurosurgery.In conjunctions with the literature,this review focused upon the applications of IONM during pediatric neurosurgery.