Application And Significance Of Neuroelectrophysiological Monitoring Technology In Intracranial Aneurysm Surgery

Objective:To explore the clinical value and significance of neuroelectrophysiological monitoring technique in the operation of intracranial aneurysms.Methods:The data of patients undergoing intracranial aneurysm surgery from September 2017 to September 2019 were collected from the First Hospital of Shanxi Medical University according to the inclusion and exclusion criteria.Collect patient data that meets the inclusion and exclusion criteria.According to whether neuroelectrophysiological monitoring technology was used in the operation,patients were divided into the monitoring group(n = 35)and the blank control group(n = 35).Preoperative clinical evaluation was performed on the basis of Hunt-Hess grading and Glasgow Coma Score(GCS).During the operation,the monitoring group used the American Nicolet Endeavor CR16 channel monitor was used to monitor Somatosensory evoked potentials(SEP),Motor evoked potentials(MEP),and Brainstem auditory evoked potential(BAEP).According to the abnormal changes of various indexes monitored during the operation,we can know whether there is cerebral ischemia in the process of operation.The indexes of reoperation rate,length of stay,incidence of complications,mortality and so on were compared between the two groups,and the correlation between intraoperative monitoring results of the monitoring group and postoperative neurological status was studied.The clinical value and significance of intraoperative neuroelectrophysiological monitoring in intracranial aneurysms were analyzed.Results:1.Of the 35 patients in the control group,9 developed severe neurological dysfunction and 3 died.2.Among the 35 patients in the monitoring group,2 patients had no SEP,2 patients had no MEP,and the other patients could be extracted(the first extraction rate was 94.3%).None of the patients had complications caused by electrophysiological monitoring.3.In the monitoring group,there were 3 patients who had no significant changes in intraoperative monitoring indexes and mild hemiplegia after operation,all recovered before discharge,and no new neurological dysfunction was found during follow-up.4.In 12 patients,SEP,MEP,and BAEP showed reduced amplitude or disappeared waveform.After active intervention during the operation,7 cases returned to normal,and no new neurological dysfunction occurred after the operation.4 patients had abnormal muscle strength of limbs in different degrees,and 1 patient died after surgery.The monitoring group was significantly better than the control group in terms of postoperative complications such as complications and length of hospital stay,and the difference was statistically significant(P <0.05).Conclusion:It is safe and effective to use electrophysiological monitoring technology in the clipping operation of intracranial aneurysm.SEP,MEP and BAEP can detect the changes of cerebral blood flow.The combination of the three can improve the sensitivity and reliability of monitoring.According to the changes of monitoring indicators,corresponding interventions can be taken during the operation to reduce the incidence of adverse events,improve the safety of operation and improve the prognosis of patients.