神经电生理监测在三叉神经痛微血管减压术中的价值

Application value of electrophysiological monitoring in microvascular decompression for trigeminal neuralgia

目的评价三叉神经痛微血管减压术中应用神经电生理监测的价值。方法回顾性分析2013-09—2017-03郑州大学第二附属医院院神经外科152例行微血管减压术治疗的原发性三叉神经痛患者的临床资料,以术中使用TSEP、BAEP监测的110例患者为观察组,未使用神经电生理监测的42例患者为对照组,对比分析2组有效率(含显效、好转)以及面瘫、眩晕、面部麻木及听力下降等并发症的发生情况。结果观察组术后有效率94.5%(104例),出现眩晕3例(3%);对照组术后有效率76.2%(32例),出现眩晕10例(23.8%),听力下降2例(4.8%),面部麻木5例(11.9%),面瘫1例(2.4%)。2组术后疗效及并发症发生率差异均有统计学意义(P<0.05)。结论术中神经电生理监测可有效对术者实时预警,避免脑神经损伤,保障微血管减压术的效果,同时减少术后并发症。

Objective To evaluate the value of electrophysiological monitoring in microvascular decompression of trigeminal neuralgia.Methods 152 cases of primary trigeminal neuralgia treated by microvascular decompression from September 2013 to March 2017 in neurosurgery department of our hospital were retrospectively analyzed.110 patients who were monitored by TSEP and BAEP during operation were taken as observation group and 42 patients who were not monitored by neuroelectrophysiology were taken as control group.Foremore,compared and analyzed the effective rate(including marked effect and improvement)and the occurrence of complications such as facial paralysis、vertigo、facial numbness and hearing loss of the two groups.Results The effective rate of the observation group was 94.5%(104 cases).Vertigo occurred in 3 cases(3%).The effective rate of the control group was 76.2%(32 cases),10 cases(23.8%)had vertigo,2 cases(4.8%)had hearing loss,5 cases(11.9%)had facial numbness,and 1 case(2.4%)had facial paralysis.There were significant differences in curative effect and complication rate between the two groups after microvascular decompression(P<0.05).Conclusion Intraoperative neuroelectrophysiological monitoring can effectively warn the surgeon in real time,avoid cranial nerve injury,ensure the effect of microvascular decompression,and reduce postoperative complications.