Application of neuroelectrophysiological monitoring in interventional surgery for acute cerebral infarction
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目的 探讨术中神经电生理监测在急性脑梗死介入治疗中的应用效果.方法 回顾性分析2020年12月至2023年6月就诊于西安市第九医院神经外科进行急性脑梗死介入手术的患者,筛选其中心源性栓塞并采用术中电生理监测病例40例,比较患者术前、术中、术后3个月的美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分结果情况.结果 40例患者均进行了血管内治疗,并成功取出血栓,术前患者的患侧体感诱发电位及运动诱发电位较健侧均出现波幅不同程度下降,术后波幅恢复超50%者23例,恢复超30%者15例,2例未见明显恢复;术后3个月内NIHSS评分好转38例,无改善1例,死亡1例.结论 在急性脑梗死介入手术中应用神经电生理监测能有效地判断患者术前神经功能状态及术后恢复预期,提高手术有效性,对后期康复具有一定指导意义.
Objective To explore the application effect of intraoperative neurophysiological monitoring in interventional treatment of acute cerebral infarction.Methods Retrospective analysis was conducted on patients who underwent acute cerebral infarction intervention surgery at the Neurosurgery Department of Xi'an Ninth Hospital from December 2020 to June 2023.Among them,40 cases of cardioembolic embolism were screened and intraoperative electrophysiological monitoring was used.The National Institute of Health stroke scale(NIHSS)scores of the patients were compared before,during,and 3 months after surgery.Results All 40 patients underwent endovascular treatment and successfully removed the thrombus.Prior to surgery,the affected side of the patient's somatosensory evoked potential and motor evoked potential showed varying degrees of decrease in amplitude compared to the healthy side.After surgery,23 patients recovered amplitude by more than 50%,15 patients recovered by more than 30%,and 2 patients did not show significant recovery;Within 3 months after surgery,there were 38 cases with improved NIHSS scores,1 case without improvement,and 1 case died.Conclusion The application of neurophysiological monitoring in interventional surgery for acute cerebral infarction can effectively determine the preoperative neurological function status and postoperative recovery expectations of patients,improve surgical effectiveness,and have certain guiding significance for later rehabilitation.
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