[1]王伟,廉海平,王拓,等.脑运动功能区病变患者术中采用神经电生理监测对其预后评估的作用[J].第三军医大学学报,2017,39(16):1664-1668.
 WANG Wei,LIAN Haiping,WANG Tuo,et al.Intraoperative neuromonitoring for patients with brain lesions in motor eloquent areas and its effect on postoperative prognosis[J].J Third Mil Med Univ,2017,39(16):1664-1668.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
39卷
期数:
2017年第16期
页码:
1664-1668
栏目:
临床医学
出版日期:
2017-08-30

文章信息/Info

Title:
Intraoperative neuromonitoring for patients with brain lesions in motor eloquent areas and its effect on postoperative prognosis
作者:
王伟廉海平王拓王茂德
西安交通大学第一附属医院神经外科
Author(s):
WANG Wei LIAN Haiping WANG Tuo WANG Maode

Department of Neurosurgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaannxi Province, 710061, China

关键词:
术中电生理监测运动功能区手术预后
Keywords:
intraoperative neuromonitoring motor eloquent areas operation prognosis
分类号:
R181.32;R651.11;R741.044
文献标志码:
A
摘要:

目的      探讨术中神经电生理监测(intraoperative neuromonitoring,IONM)对脑运动功能区病变患者术后肌力与人体机能状态量表(Karnofsky performance scale,KPS)评分的影响。方法     回顾性分析2007年1月至2016年11月西安交通大学第一附属医院神经外科收治的运动区病变并行开颅手术患者的临床资料。对比IONM组与非监测组(nonIONM)手术前与术后14 d肌力与KPS评分无变化或改善的病例比例。单变量Logistic回归分析影响术后肌力与KPS评分变化的危险因素。结果    共纳入209例,其中IONM组129例,non-IONM组80例。IONM组术后14 d肌力和KPS评分较术前无变化或改善的比例显著高于non-IONM组(P<0.05)。IONM是术后肌力无变化或改善的保护性因素(OR=2.075,95%CI:1.509~4.068,P=0.033),以及术后KPS评分无变化或改善的保护性因素(OR=2.481,95%CI:1.254~4.910,P=0.009)。结论     IONM用于运动功能区病变手术,可降低术后运动功能损害的发生率,提高患者术后生存质量。

Abstract:

Objective      To determine the effect of intraoperative neuromonitoring (IONM) on the grade of postoperative muscle strength grading scale and the score of Karnofsky performance scale (KPS) for the patients with intracerebral lesions located in motor eloquent areas. Methods     A retrospective study was performed in the patients with intracerebral lesions located in motor eloquent areas who were surgically treated in our department from January 2007 to November 2016. In 14 d after operation, the changes of KPS and muscle strength grade were compared between IONM group and non-IONM group. Furthermore, univariate logistic regression analysis was performed to reveal potential risk factors for postoperative KPS and muscle strength grade.  Results     Two hundred and nine cases were enrolled, including 129 cases in the IONM group and 80 in the non-IONM group. There were more patients experienced an even or improved KPS and muscle strength grade post-operatively in the IONM group than the non-IONM group (P<0.05). Univariate logistic regression analysis showed that IONM was a protective factor for even or improved muscle strength grade (OR=2.075, 95%CI: 1.509~4.068, P=0.033) and KPS (OR=2.481, 95%CI: 1.254~4.910, P=0.009). Conclusion     IONM in the resection for lesions located in motor area can contribute to the reduction of postoperative motor impairment and improvement of postoperative quality of life.

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更新日期/Last Update: 2017-08-23