上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (12): 1674-.doi: 10.3969/j.issn.1674-8115.2017.12.017

• 论著（临床研究） • 上一篇    下一篇

颈椎术中体感诱发电位监测与术后疗效分析

黄晓虹，严彬，刘佳，王晓宁   

  1. 上海交通大学  医学院附属瑞金医院手术室，上海 200025
  • 出版日期:2017-12-28 发布日期:2018-01-10
  • 作者简介:黄晓虹（1974—），女，主管护师，本科；电子信箱：huangxh_74@163.com

Analysis between somatosensory-evoked potential monitoring and postoperative effect in anterior cervical discectomy and fusion

HUANG Xiao-hong, YAN Bin, LIU Jia, WANG Xiao-ning   

  1. Operating Theatre, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2017-12-28 Published:2018-01-10

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摘要： 目的 · 分析术中体感诱发电位（SEP）监测与颈椎病患者功能恢复的关系，预测术后疗效。方法 · 总结回顾了2014 年 11 月—2016 年 4 月 99 例接受颈椎前路减压手术的患者临床资料。术中对所有患者进行了 SEP 监测，根据术中 SEP 的变化将患者分 为 SEP 明显改善组（SEP 波幅上升 >50%）和 SEP 一般改善组（SEP 波幅上升≤ 50%）；比较 2 组患者术前、术后日本骨科学会脊髓 功能（JOA）评分，并以此评估疗效。结果 · 患者的平均改善波幅为（181.624±371.311） %，2 组患者基本资料及术前 JOA 评分无差 异，术后1 周 JOA 评分以及改善率比较差异有统计学意义（均P=0.000），术后6 个月JOA 评分以及改善率比较差异无统计学意义 （均 P>0.05）。 结论 · SEP 的改善与 JOA 评分的改善具有一致性，提示早期恢复良好，但对长期预后的评价，不能用 SEP 是否改善来 衡量。

关键词: 颈椎, 体感诱发电位监测, 术后, 疗效

Abstract:

Objective · To analyze the relationship between somatosensory-evoked potential (SEP) monitoring and function recovery in anterior cervical discectomy and fusion, and predict the postoperative therapy effect.  Methods · The clinical data of 99 cervical spondylotic myelopathy patients (from Nov 2014 to Apr 2016) were retrospectively collected. SEP monitoring was used during operation. According to variations of SEP, patients were divided into obvious group (SEP improved more than 50%) and normal group (SEP improved less than or equal to 50%). The therapy effect was evaluated with Japanese Orthopedic Association Scoring System (JOA) score.  Results · For all patients, mean SEP was improved by (181.624±371.311)%. For two groups, there was no difference in basic information and JOA score before operation. There was significant difference between two groups in JOA score and improved rate one week after operation (both P=0.000), but no difference between two groups in JOA score or improved rate six months after operation (both P>0.05).  Conclusion · SEP improvement is consistent with JOA score. Obvious improvement in SEP indicates a good recovery in shortterm, but not suitable for evaluating long-term effect.

Key words: cervical vertebra, somatosensory-evoked potential monitoring, postoperative, therapy effect