A QUARTER CENTURY EXPERIENCE WITH INTRAOPERATIVE NERVE ACTION-POTENTIAL RECORDING
A QUARTER CENTURY EXPERIENCE WITH INTRAOPERATIVE NERVE ACTION-POTENTIAL RECORDING
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DOI：
10.1017/s0317167100047338
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发表时间：
1993-02-01
影响因子：
3
通讯作者：
HAPPEL, LT
中科院分区：
文献类型：
--
作者：
KLINE, DG;HAPPEL, LT
回顾了术中神经动作电位(NAP)记录的原理、基本考虑和技术。总结了25年来在数千名患者中使用该技术的经验。最常见的严重神经损伤是使其保持连续性。切除这种正在再生的病变对患者是一种极大的伤害，就像探查而不修复一个很少或没有有效的自然恢复潜力的病变一样。连续性病变的频率以及在最初几个月通过肌电图术进行评估的困难，更不用说通过手术检查了，这导致了术中NAP记录的发展。在神经松解术中，93%的患者恢复了良好的功能。如果病变的切除是基于没有午睡，损伤无一例外地是神经损伤和/或没有修复的有效恢复潜力很差的损伤。一些损伤处有一个小睡，但横切区的一部分看起来更严重。通过使用午睡录音，进行了裂开修复，通常效果良好。
The rationale, basic considerations, and technique of intraoperative nerve action potential (NAP) recording have been reviewed. Experience using this technique in several thousand patients over a 25 year period has been summarized. The most frequent serious nerve injury is one that leaves it in continuity. Resection of such a lesion that is regenerating does the patient a great disservice as does exploration without repair of one with little or no potential for useful spontaneous recovery. The frequency of lesions in continuity as well as the difficulties in evaluating them in the early months by electromyography let alone by surgical inspection has led to the development of intraoperative NAP recording. Where neurolysis was based on a recordable NAP across a lesion in continuity, 93% recovered good function. Where resection of the lesion was based on absence of an NAP, the injury was, without exception, neurotmetic and/or one with poor potential for useful recovery without repair. Some lesions had an NAP across their lesion but a portion of the cross-sectional area appeared more seriously injured. By use of NAP recordings, a split repair was done and usually with good results.