听神经瘤术中cmap对面神经功能的评估

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1、授予单位代码10089学号或申请号20153244中国图书分类号R651.1+1HebeiMedicalUniversity硕士学位论文专业学位听神经瘤术中CMAP对面神经功能的评估研究生：杨松海导师：孙晓枫教授专业：外科学二级学院：河北医科大学第二医院2018年3月目录中文摘要········································································································1英文摘要······································

2、··································································2研究论文听神经瘤术中CMAP对面神经功能的评估前言········································································································4材料与方法·····················································································

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4、············································11讨论········································································································12结论········································································································15参考文献·····················

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6、·····24个人简历········································································································25中文摘要听神经瘤术中CMAP对面神经功能的评估摘要目的：随着显微外科手术技术的不断进步和术中神经电生理监测技术的发展，术中面神经的解剖保留率显著提高。由于术中面神经功能的评估对术者具有重要的指导作用，对患者术后面神经恢复情况至关重要。我们在听神经瘤显微外科手术中监测面神经复合神经肌肉动作电位（CMAP），研究CMAP在术中面神经功能保护及

7、预后判断方面的作用。通过对不同患者肿瘤切除后刺激脑干端面神经获得的不同刺激阈值来评估术后面神经功能。方法：严格筛选2015年12月至2017年10月河北医科大学第二医院收治的听神经瘤（术后病理证实）患者38例。术前、术后对患者进行面神经功能House-Brackmann分级，术前选取面神经功能Ⅰ-Ⅱ级并且术中证实面神经解剖保留患者入组；所有患者均采用枕下乙状窦后入路切除肿瘤；利用一次性神经探针在术后刺激面神经脑干端，从最小刺激（0.03mA）开始，直到产生复合动作电位(CMAP)的最小刺激，作为刺激阈值。患者分别于术后1天、3天、1周、1月、3月进行