选择性脊神经后根切断术中电生理监测的研究

发布时间：2018-04-13 23:15

本文选题：选择性脊神经后根切断术 + 电生理监测　；参考：《中国矫形外科杂志》2017年03期

【摘要】：[目的]分析选择性脊神经后根切断术中应用电生理监测得到的数据与术后解痉情况的相关性。[方法]选择2014年3月~2015年9月在本院行选择性脊神经后根切断术的患者52例,术中测定切除神经分束的阈值、保留神经分束的阈值,并记录切除比例,随访6个月分别统计内收肌群和小腿三头肌肌张力降低情况,术后6个月肌张力0级者为观察组,肌张力未降低至0级者为对照组,分析其术中监测数据与手术效果的相关性。记录术中肛门括约肌肌电出现动作电位的频率,并随访术后有无出现相应并发症。[结果]通过秩和检验分析除L2切除神经分束阈值和剩余神经分束阈值两组间比较有差异外(P0.05),其余节段的切除比例、切除神经分束阈值和剩余神经分束阈值在两组间比较差异均无统计学意义(P0.05)。术中监测发现7束神经分束出现肛门括约肌肌电波形,术后无相应并发症发生。[结论]脊神经后根切除比例、术中监测切除神经分束和保留神经分束的阈值与解痉程度无相关性,但术中应避免切除支配肛门括约肌的分束而避免相应并发症的发生。
[Abstract]:[objective] to analyze the correlation between electrophysiological monitoring and postoperative spasmolysis in selective posterior rhizotomy.[methods] Fifty-two patients who underwent selective posterior rhizotomy of spinal nerve from March 2014 to September 2015 were selected.After 6 months of follow-up, the decrease of adductor muscle group and triceps muscle tension of the lower leg were statistically analyzed. The patients with 0 grade of muscle tension were observed as the observation group, and those who did not decrease to grade 0 were taken as the control group. The correlation between the intraoperative monitoring data and the operative effect was analyzed.The frequency of action potential in anal sphincter was recorded.[results] the resectable ratio of the other segments was analyzed by rank sum test except for the difference between the two groups.There was no significant difference between the two groups in the excised nerve beam splitting threshold and the residual nerve beam splitting threshold in the two groups (P 0.05).The intraoperative monitoring showed that the sphincter sphincter of 7 bundles of nerves appeared in the shape of electric wave, and no corresponding complications occurred after operation.[conclusion] the ratio of posterior root resection of the spinal nerve, the threshold value of the resected and reserved nerve bundles is not correlated with the degree of spasmolysis, but the resection of the sphincter sphincter innervated the sphincter should be avoided during the operation and the corresponding complications should be avoided.
【作者单位】：广东三九脑科医院脑瘫脊髓外科;
【基金】：广东省医学科学技术研究基金资助项目(编号:B2014329)
【分类号】：R651.2

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