神经肌电图对坐骨神经损伤的术中应用

Application of Intraoperative Electrophysiologyin Injuries of Sciatic Nerves

目的 探讨神经肌电技术在坐骨神经损伤的术中应用价值。方法 对 2 4例患者共 2 4根腓总神经和19根胫神经损伤进行术中电生理功能评价 ,研究与术前电生理诊断间差异 ,并作预后随访分析。结果 术中与术前的电生理诊断结果间存在差异。术中损伤近端存在复合肌肉动作电位 (compoundmuscleactionpotential,CMAP)和远端存在躯体感觉诱发电位 (somatosensoryevokedpotential,SEP)的损伤神经总体恢复较好。手术前后比较 ,胫神经预后较腓总神经好。结论 术中神经电生理检测能完善术前对神经受损程度的诊断 ,术中能检测到SEP和CMAP的损伤神经 。

Purpose: To diacuss the importance of intraoperative electrophysiological technique in the injuries of sciatic nerves. Methods: By analyzing the nerve functions of 24 patients with 24 common feroneal nerves and 19 tibial nerves injuried before the operation and during the operation, there were differences between them. According to the results detected in the operation, we followed-up the nerve recoveries after operation. Results: There were differences between the intraoperative and the preoperative electrophysiological findings. The injuried nerves, which could be recorded compound muscle action potential (CMAP) in the dominated muscles in the upper end and somatosensory evoked potential (SEP) on the cerebral cortex in the lower end during the operations, had quite good recoveries. The recoveries of the tibial nerves were better than that of the common feroneal nerves. Conclusions: Using the electrophysiological technique can make us diagnose the degree of injuries of the sciatic nerves more conveniently. The injuried nerves, which could be recorded SEP and CAMP during the operation, had better recoveries.