简介:目的探讨不同剂量的丙泊酚颈内动脉注射对语言及记忆功能优势半球测试的影响,对比不良反应的发生情况。方法对40例难治性癫痫患者采用颈内动脉注射丙泊酚进行Wada试验,根据所采用剂量不同分为10mg和7mg两组。对比两组不同剂量颈内动脉注射组的语言、记忆功能测试情况,计算注药后半球失活的持续时间,并观察不良反应的发生情况。同时收集患者的年龄、病程、全量表智商等相关数据,分析两不同剂量组的差异。结果所有患者均完成了语言优势半球测试,28例患者完成了记忆优势半球的测试。两组在年龄、病程、全量表智商方面的差异无统计学意义(均P〉0.05);注药后左侧半球和右侧半球的失活时间,两组之间的差异均无统计学意义(均P〉0.05)。两组患者记忆优势半球的测试成功率分别为56%和93%,差异有统计学意义(P=0.03)。两组均有发生Ⅰ、Ⅱ级的不良反应,但7mg组未出现Ⅲ级不良反应,两组不良反应发生率的差异有统计学意义(P=0.01)。结论采用丙泊酚7mg的剂量进行颈内动脉注射,可顺利完成语言优势半球的测试,提高记忆功能测试的成功率,减少不良反应的发生,是一个值得推荐的剂量。
简介:摘要Wada试验是目前评估语言优势半球和预测术后记忆功能改变的"金标准"。而应用依托咪酯作为麻醉剂的eSAM-Wada试验弥补了传统Wada试验评估时间有限的缺点,可以更好地评估语言和记忆功能。本文报道1例左颞动静脉畸形合并癫痫的患者,联合血管超选技术完成eSAM-Wada试验,并依据其结果给予患者左颞动静脉畸形血管栓塞术+动静脉畸形血管团和致痫灶切除术,术中保留海马结构,最大程度地保护了患者的神经功能。血管超选技术与eSAM-Wada试验技术相结合,有望成为一项新的评估方法,辅助颞叶外科手术决策的制定。
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