体感诱发电位监测在前循环动脉瘤血管内介入治疗中的应用

The application of somatosensory evoked potential monitoring during endovascular embolization of anterior circulation aneurysm

目的 探讨体感诱发电位（SEP）监测技术在颅内前循环动脉瘤血管内介入治疗中的应用价值。方法将2007年3月至2010年7月期间102例前循环动脉瘤血管介入栓塞术患者根据研究开始前生成的随机编码人组，52例术中进行SEP动态监测，50例术中未用该监测手段，对比分析两组术后1d新发神经功能障碍及6个月后随访的预后情况（良好、致残、死亡）。结果两组患者术后出现新的神经功能障碍例数差异有统计学意义（P〈0．01），6个月后随访预后良好和致残比率组间差异均有统计学意义（P〈0．05），而死亡率组间差异无统计学意义（P〉0．05）。结论在介入栓塞术中应用SEP监测可以早期反映前循环供血区神经组织由于缺血引起的功能异常，并及时给予术中干预，对降低患者致残率及提高预后良好率有极其重要的意义。

Objective We applied somatosensory evoked potential （SEP） monitoring during endovascular embolization for intracranial anterior circulation aneurysm , and explored the values. Methods From March 2007 to July 2010 we treated 102 patients of intracranial anterior circulation aneurysm with endovascular embolization. 102 patients were randomly classified two groups, group one with 52 patients with SEP monitoring and group two with 50 patients without SEP monitoring. Postoperative new nerve impairment and prognosis （good prognosis, disability, death） at the six month after leaving hospital of two groups were compared statistically. Results Comparing the monitoring group with the non - monitoring group, the numbers of patients with postoperative new nerve impairment was statistically significant differences （ P 〈0. 01 ）, the rates of good prognosis and disability were statistics difference （ P 〈0. 05）. But there was not statistics difference at the rates of death （ P 〉 0. 05 ）. Conclusions Applying SEP monitoring in endovascular embolization can early reflect abnormal function of the brain tissue which supplied by anterior circulation. It is significant to reduce the occurrence of disability and improve prognosis.