EMG、SEP联合监测在腰骶部手术中的应用

摘要

目的：探讨肌电图（EMG）、体感诱发电位（SEP）联合监测技术在腰骶部手术中的应用价值及指导意义。方法：回顾性分析2012年3月～2014年5月在我院行腰骶部手术的158例患者，采用EMG、SEP技术同时监测神经根及脊髓的功能。结果：158例患者中，有2例术中SEP正常，EMG异常；有4例EMG正常，SEP异常。SEP正常而EMG异常者中，1例术中未予干预，术后出现神经症状；另1例术中发现后及时干预，术后患者未出现神经症状。EMG正常而SEP异常者中，3例经干预后SEP波幅恢复，术后均未出现神经症状，1例经干预后 SEP波幅未恢复，术后出现神经症状。结论：EMG、SEP两种监测模式在腰骶部手术监测过程中是相辅相成的，仅单凭某一项都不能完整地监测腰骶部的神经功能；SEP的监测中波幅的敏感性及特异性明显优于潜伏期的改变。%Objective:To explore the utilized value and significance of EMG combined with SEP monitoring during lumbosacral operation .Methods:Retrospective analysis of 158 patients with lumbosa‐cral operation in our hospital from March 2012 to May 2014 ,was made with EMG and SEP in monitoring the functions of spinal cord and nerve root .Results:In 158 patients ,2 were normal in SEP but abnormal in EMG ,4 were normal in EMG but abnormal in SEP .with normal SEP and abnormal EMG .In those with normal SEP and abnor mal EMG one case did not received intervention and showed nerve symptom .An‐other case with timely intervention during operation showed nerve symptom after operation .In those with normal EMG and abnormal SEP ,3 cases’s SEP amplitude was recovered after intervention and didn’t show any nerve symptom .One’s SEP amplitude was not recovered after intervention and showed nerve symptom .Conclusion:EMG and SEP monitorings are complemen tary during lumbosacral operation .Nei‐ther of them can not monitor the nerve function completely .The sensitivity and specificity of amplitude obviously surpass latency in SEP monitoring .