Chiari畸形并脊髓空洞术中体感诱发电位联合诱发肌电图监测

Evaluation on monitoring of SEP and evoked EMG in microsurgery for Chiari malformation with syringomyelia

目的评价体感诱发电位(SEP)联合诱发肌电图(EMG)监测在Chiari畸形并脊髓空洞显微手术中的保护作用。方法对23例Chiari畸形并脊髓空洞病人行术前、术中和术后SEP及EMG全程监测,术中随时将监测到的信息反馈给术者,据此及时调整操作。结果术中监测SEP以波幅较基准电位下降不超过50%,潜伏期延长不超过10%为安全范围;EMG以自发性肌电图无刺激性强直放电为安全范围。术后无严重并发症发生。结论Chiari畸形并脊髓空洞显微手术中行SEP和EMG全程监测,能及时反映脑干及脊髓功能的变化,提高操作安全性,减少并发症。

Objective To evaluate the monitoring function of somatosensory evoked potential （SEP） and evoked electromyography （EMG） in microsurgery for Chiari malformation with syringomyelia. Methods SEP and EMG monitoring were performed before, during and after the operation in 23 patients. The data gained from monitoring were sent to the operators, and the operation was adjusted accordingly. Results The decrease of SEP amplitude less than 50% of normal potential, the prolongation of the latency less than 10% and EMG having no strong evoked discharge were within the safe range, thus suggesting no injury to the brain-stem. No severe postoperative complication occurred. Conclusion Intraoperative monitoring of SEP and EMG may reduce the risk of iatrogenic injury to the brain-stem and decrease postoperative complication.