术中部分肌肉松弛下多组颅神经监护对术后神经功能的影响

The effect of intraoperative cranial nerve monitoring under partial muscular relaxation on postoperative nerve function in posterior cranial fossa surgery

目的评价术中部分肌松下应用多组颅神经监护对患者术后短期神经功能的影响。方法70例择期行后颅窝肿瘤切除术患者，随机分为监测组（IOM组）和对照组（N组），每组35例。IOM组术中保持4个成串刺激（TOF）T4消失，同时采用面神经、三叉神经、舌咽神经完整性监护技术。记录两组患者术前和术后8d三组颅神经功能。结果IOM组较N组术后短期良好面神经功能（H-BⅠ-Ⅲ级）保存率明显提高。结论部分肌松下多组颅神经监护能显著提高后颅窝肿瘤患者术后短期面神经功能保留率。

Objective To study the effects of intraoperative cranial nerve monitoring under partial muscular relaxation on postoperative short-term nerve function in the patients undergoing the surgery in the postierior cranial fossa. Methods Seventy ASA class Ⅰ or Ⅱ patients were randomly allocated to two groups with 35 cases each. The patients in group IOM were given serial monitoring on the facial nerve, trigeminal nerve and glossopharyngeal nerve under partial muscular relaxation keeping T4 on the train of four stimulation（TOF） absent during operation. The patients in group N were not given TOF monitoring as the controls. The functions of the three nerves were evaluated before and on the 8th postoperative day. Results The better preservation rate of facial nerve function graded by H-B was markedly higher in group IOM than that in griup N postoperatively. Conclusion Intraoperative cranial nerve monitoring under Partial muscular relaxation is helpful to increase the preservation rate of facial nerve function in posterior cranial fossa surgery.