Chiari_Ⅰ型畸形；_手术；_诱发电位_

Chiari Ⅰ型畸形手术前后的诱发电位研究

http://www.100md.com 《中国矫形外科杂志》 2006年第11期

Chiari,Ⅰ型畸形；,手术；,诱发电位,,Chiari,Ⅰ型畸形；,手术；,诱发电位,ChiariⅠ型畸形手术前后的诱发电位研究,1材料与方法,2结果,参考文献：

     摘要：[目的]研究ChiariⅠ型畸形患者手术前后的诱发电位的变化规律，观察手术前脊髓空洞的程度与诱发电位变化之间的关系。[方法]对2003年10月~2004年9月收治的15例Chiari Ⅰ型畸形患者，采取寰枕减压术、硬膜成形术，手术前第1~3 d和手术后第10~14 d分别检测BAEP、SEP、MEP，然后对这些患者经过6个月的随访，进行脊髓功能JOA评分和MRI复查。[结果]15例ChiariⅠ型畸形患者手术前14例SEP、MEP异常，手术后临床症状均有所缓解，脊髓功能JOA改善率为603%，MRI复查显示脊髓空洞明显缩小，诱发电位SEP检测P40N22、N20N13潜伏期与MEP检测中枢传导时间CMCT值和BAEP检测Ⅰ~Ⅴ峰间期，三者测的值比术前均缩短，差异有显著性。同时发现Chiari畸形患者的SEP与MEP检查测得皮层值术后比术前缩短，差异有显著性，而外周神经传导时间术后与术前比较却没有任何变化。[结论]诱发电位可以作为评价Chiari Ⅰ型畸形手术前后效果的客观而相对准确的检查方法。

    关键词：Chiari Ⅰ型畸形；手术；诱发电位

    Evoked potentials research in preandpost operation on Chiari Ⅰ malformation∥ZONG Shaohui，WANG Zhenyu Department of Spinal Diseases,the 1st Affiliated Hospital of Guangxi Medical University,Nanning 530021

    Abstract：[Objective]To study the change rules of evoked potentials in preandpost operation of Chiari Ⅰ malformation patients,and observe the relationship between the syrinxs and evoked potentials[Method]During the period of October 2003 to September 2004,15 patients with Chiari Ⅰ malformation were collected,which underwent suboccipital craniectomy and duraplastyThe patients brainstem auditory evoked potentials and somatosensory evoked potentials and motor evoked potentials were were examined in 1~3 days before operation and 10~14 days after operationAfter six months followup,these patients underwent MRI countercheck and JOA grade[Result]The clinic symptoms were relaxed in 15 cases with Chiari Ⅰ malformationThe recovery rate of JOA score was 603%,and syrinx were reduced in MRI checkThere was shorten of cervicomedullary central conduction time in the examine of BAEP(Ⅰ~Ⅴ)and SEP(P40N22,N20N13)and MEP(CMCT),which has markedly difference compare to foreoperationAt the same time,we discoveried it was shorten of cortical conduction time in the examine of BAEP and SEP and MEP,however,the peripheral conduction time were not ever change[Conclusion]Through the method of evoked potentials,improvement of Chiari Ⅰ malformation nerve function can be assessed preandpost operation ......

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