神经电生理监测在儿童第四脑室肿瘤显微手术中的临床应用

Application of intraoperative neurophysiologic monitoring to microsurgery for the fourth ventricular tumors in children

目的神经电生理监测在探讨儿童第四脑室肿瘤显微手术中的应用价值。方法回顾性分析2007年1月至2012年12月46例神经电生理监测下显微手术(监测组)及45例常规显微手术(对照组)治疗的儿童第四脑室肿瘤患者的临床资料。结果手术全切除75例(监测组38例,对照组37例);监测组和对照组出现新颅神经损伤症状发生率分别为0和11.1%、原有颅神经损伤症状加重比率分别为2.2%和13.3%,差异有统计学意义(P<0.05);永久性神经损伤发生率分别为0和6.7%,差异无统计学意义(P>0.05)。结论第四脑室肿瘤患儿显微手术中进行神经电生理监测可以最大可能切除肿瘤,减少术中脑干损伤。

Objective To explore the role of intraoperative neurophysiologic monitoring in microsurgery for the fourth ventriculartumors in children.MethodsThe clinical data of 91 children with the fourth ventricle tumors, of whom, 46（observed group） underwentthe microsurgery under intraoperative neurophysiologic monitoring and 45（control group） underwent conventional microsurgery in ourhospital from January, 2007 to December, 2012, were analyzed retrospectively.ResultsOf 46 children in the observed group, 38 underwent total resection of the tumors and 8 subtotal. Of 45 children in the control group, 37 underwent total resection of the tumors and8 subtotal. The rate（2.2%） of aggravation of the symptoms of the original cranial nerve injury was significantly lower in the observedgroup than that（13.3%） in the control group（P0.05）.ConclusionThe intraoperative neurophysiologic monitoring is helpful to reducethe brain stem injury in the children with the fourth ventricular tumors.