皮层体感诱发电位联合直接电刺激术在大脑运动感觉功能区定位的效果评价

Evaluation of Cortical Somatosensory Evoked Potential Joint Direct Electrical Stimulation in the Positioning of Cerebral Motor and Sensory Function Areas

目的探讨皮层体感诱发电位、直接电刺激术联合监测在运动感觉功能区占位患者术中监测的临床应用。方法实验组选取40例运动感觉区占位的病人,术中均采用皮层体感诱发电位联合直接电刺激术定位功能区。对照组选取运动感觉区占位的病人40例,术中未定位功能区。两组病人均行术前术后神经系统检查,以术后2周两组病人的肌力、切除程度做为评价指标。结果术后肌力下降实验组14例(占35%),对照组21例(占52.5%),P=0.028,P<0.05;实验组有9例术中成功定出下行运动通路(占22.5%);术后感觉减退实验组2例(占5%),对照组1例(占2.5%),P=0.841(P>0.05);实验组28例全切,12例近全切;对照组27例全切,13例近全切(P=0.809)。结论术中采用皮层体感诱发电位波形倒置与直接皮层及下行运动通路电刺激监测技术,能在最大限度切除肿瘤的同时有效保护运动功能。

Objective To evaluation of cortical somatosensory evoked potential joint direct electrical stimulation in the positioning of cerebral motor and sensory function areas. Methods Experimental group selected 40 eases with ttunors in motor and sensory areas and performed both cortical somatosensory evoked potential and direct electrical stimulation positioning functional areas. Control group selected 40 patients with tumors in motor and sensory areas and did not targeted functional areas. The two groups of patients underwent preoperative and postoperative neurological examination. Results The muscle strength declined in experimental group of 14 persons （35 % ） and in Control group 21 persons （52.5%） （ P 〈 0.05） ; in experimental group, nine cases were identified successfully descending motor pathway （22.5%）. 2 cases with hypoesthesia after operation were found in experimental group and 1 case in control group （ P 〉 0.05） ; in experimental group, 28 cases performed total resection and in control group, 27 eases performed total resection （ P 〉 0.05）. Conclusion Intraoperative use of somatosensory evoked potential waveform inversion and direct cortical electrical stimulation and the descending motor pathway monitoring technology are able to remove the tumor and protect motor function to a maximum extent at the same time.