摘要 目的：研究双耳刺激、双侧记录的脑干听觉诱发电位在脑干肿瘤手术中的监护价值。方法：对30例听力正常的健康受试者用双耳刺激、双侧记录和单耳刺激、同侧记录的方法检测其脑干听觉诱发电位；对16例脑干肿瘤患者，用双耳刺激、双侧记录的脑干听觉诱发电位进行术中连续监护。结果：所有病人在手术操作时，均出现BAEPs改变，按其改变程度大致可分为轻度改变、中度改变和重度改变三种。轻、中度改变者，临床效果良好；重度改变者，预后不良，甚至死亡。结论：双耳刺激双侧记录的BAEPs更适用于手术中监护；术中BAEPs改变程度能反映脑干功能受影响程度和能预测预后；Ⅲ波和/或V波的PL，Ⅰ-Ⅲ、Ⅰ-Ⅴ、Ⅲ-Ⅴ的IPL延长超过1.5ms，或者全部波形消失，是脑干功能受到不可逆损害的具体指标。

Abstract Objective: To study the value of monitoring of brain-stem auditoryevoked potentials of binaural stimulation and bilateral recording during brainstem tumoroperation. Methods: BAEPs of monoaural stimulation, ipsilateral recording and binauralstimulation, bilateral recording were determined in 30 healthy subjects with normalaudition. Intraoperative monitoring of BAEPs of binaural stimulation, bilateral recordingwere done in 16 patients with brain-stem tumors. Results: All the patients had the wavedeterioration of BAEPs during surgical procedures, which could be divided into threetypes: slight, morderate and severe changes. The patients with slight or morderate changesof intraoperative BAEPs had satisfactory results, while the patients with severe changeshad bad prognosis, even died. Conclusions: BAEPs of binaural stimulation, bilateralrecording are more appropriate to be used in intraoperative monitoring. The degree ofdeterioration of BAEPs could reflect the dysfunction of brain-stem, and could predict theprognosis. The latencies of wave Ⅲ and/or Ⅴ, or the interpeak latencies of Ⅰ-Ⅲ, Ⅲ-Ⅴ, Ⅰ-Ⅴ of BAEPs prolonged morethan 1.5 ms, or all waves of BAEPs disappeared are the signs of irreversible dysfunctionof brain-stem.

     Key words Brain-stem anditory evoked potenial(BAEP) Brain-stem Tumor Intraoperative monitoring

自70年代以来 ......