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1.江苏省中医院神经外科,江苏 南京 210029
2.江苏省人民医院神经外科,江苏 南京 210029
李海林,E-mail:yfy152@njucm.edu.cn
收稿:2025-02-10,
纸质出版:2025-11-25
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胡静,李海林,吴志强等.超声引导下置针辅助运动诱发电位和肌电图监测在脊髓手术中的应用[J].局解手术学杂志,2025,34(11):960-963.
HU Jing,LI Hai-lin,WU Zhi-qiang,et al.Application of ultrasound-guided needling assisted the motor evoked potentials and electromyography monitoring in spinal surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(11):960-963.
胡静,李海林,吴志强等.超声引导下置针辅助运动诱发电位和肌电图监测在脊髓手术中的应用[J].局解手术学杂志,2025,34(11):960-963. DOI: 10.11659/jjssx.02E025043.
HU Jing,LI Hai-lin,WU Zhi-qiang,et al.Application of ultrasound-guided needling assisted the motor evoked potentials and electromyography monitoring in spinal surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(11):960-963. DOI: 10.11659/jjssx.02E025043.
目的
2
探讨超声引导下置针辅助运动诱发电位(MEP)和肌电图(EMG)监测应用于脊髓手术对神经功能恢复的影响及预测价值。
方法
2
回顾性分析2020年1月至2024年12月在江苏省中医院接受脊髓手术的80例患者的临床资料。观察组41例患者术中采用超声引导下置针辅助MEP及EMG监测,对照组39例患者术中采用常规方法监测MEP及EMG。对比2组患者手术时间、术中出血量及术中MEP和EMG报警比例,比较2组患者术中MEP监测的敏感
性和特异性。绘制受试者工作特征(
ROC
)曲线,并计算曲线下面积(
AUC
)以分析MEP报警预测术后脊髓功能异常的效能。
结果
2
2组患者手术时间、术中出血量及术中MEP和EMG报警比例比较,差异均无统计学意义(
P
>
0.05)。观察组患者术中MEP监测敏感性、特异性及
AUC
均高于对照组(
P
<
0.05)。观察组术后MEP报警预测脊髓功能异常的敏感性、特异性和
AUC
高于对照组,差异均有统计学意义(
P
<
0.05)。
结论
2
超声引导下置针辅助MEP和EMG监测可有效提高术中神经监测的精确性,且术后MEP报警对术后神经功能异常具有较高的预测价值。
Objective
2
To explore the effect and predictive value of ultrasound-guided needling assisted motor evoked potentials (MEP) and electromyography (EMG) monitoring on neurological recovery in spinal surgery.
Methods
2
A retrospective analysis was conducted on the clinical data of 80 patients who underwent spinal surgery at Jiangsu Province Hospital of Chinese Medicine from January 2020 to December 2024. A total of 41 patients in the observation group received ultrasound-guided needling assisted MEP and EMG monitoring, and 39 patients in the control group received conventional method for MEP and EMG monitoring. The operative time, intraoperative blood loss, and the proportions of intraoperative MEP and EMG warnings were compared between the two groups, and the sensitivity and specificity of intraoperative MEP monitoring were compared between the two groups. The
receiver operating characteristic
(
ROC
) curve was plotted, and the
area under the curve
(
AUC
) was calculated to analyze the efficiency of MEP warning in predicting the dysfunction of postoperative spinal cord.
Results
2
There were no significant differences in the operative time, intraoperative blood loss, or the proportions of intraoperative MEP and EMG warnings (
P
>
0.05). The sensitivity, specificity and
AUC
of intraoperative MEP monitoring in the obse
rvation group were significantly higher than those in the control group, with statistically significant differences(
P
<
0.05). The sensitivity, specificity, and
AUC
of postoperative MEP warning in predicting the dysfunction of spinal cord in the observation group were higher than those in the control group, with statistically significant differences(
P
<
0.05).
Conclusion
2
Ultrasound-guided needling assisted MEP and EMG monitoring can effectively enhance the intraoperative neural monitoring accuracy, and postoperative MEP warning demonstrates superior predictive value for postoperative neurological dysfunction.
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