术中体感诱发电位监测联合直接皮层电刺激技术在脑功能区手术中的应用

The application of inoperative sensory evoked potential and direct cortical electrical stimu- lation technology in operation on functional area

目的：探讨皮层体感诱发电位（SEP）波形位相倒置、术中直接电刺激（DCES）联合监测定位脑功能区的方法及意义。方法：在对37例运动感觉功能区占位患者术中采用SEP波形翻转、DCES定位感觉区和运动区的前提下，手术切除病变。结果：34例病人成功引出SEP，其中25例记录到明确的SEP的位相倒置，藉此定位中央沟，其中23例患者成功引出运动诱发电位（MEP），定位出感觉、运动皮层。有3例既未引出SEP也未引出MEP。术后患者脑功能大部分好转，未出现永久性功能障碍。结论：颅内占位患者术中联合采用SEP波形位相倒置与DCES监测技术定位，能在最大限度切除肿瘤的同时有效保护运动功能。

Objective：To investigate the application of the waveform flip in cortical sensory evoked potential （SEP）, and intraoperative direct electrical stimulation （DCES） joint monitoring positioning in operation on functional areas. Methods：37 cases with lesions whose functional areas Were occupied and a- dopted sensory evoked potential （SEP） waveform flip and intraoperative direct electrical stimulation （DCES） positioning feeling and sport areas and then received operation. Results.. SEP was induced sue- cessfully in 34 cases; SEP phase inversion were clearly recorded and the central sulcus was positioned cor- rectly in 25 cases, motor evoked potential（MEP） was induced succesfully, and the sensorimotor cortex was correctly located in 25 cases. Neither SEP nor MEP were found in 3 cases only, The patients were in much better condition without any permanent dysfunction. Conclusion： Intraoperative combined with SEP waveform flip with DCES monitoring technology can resect the tumor at the most and protect the functions of patients with intracranial space occupying.