应用丙泊酚作替代的Wada试验临床分析.docVIP

DOI：10.16016/j.1000-5404.201409148 应用丙泊酚作替代的Wada试验临床分析 武 江，李文玲，岳向勇，赵 磊，张 波，陈 尧，郑 杰，郭 韬，梁传栋，董长征，康进生（050051 石家庄，河北省人民医院功能神经外科） [摘要] 目的 探讨丙泊酚可否替代异戊巴比妥钠进行Wada试验，达到确定语言和记忆优势半球效果。方法 回顾性分析河北省人民医院功能神经外科42例以丙泊酚作替代的Wada试验，总结其成功率及安全性，分析其测定语言及记忆优势半球的有效性。记录患者从肌力消失到肌力恢复到3级（T3/5）和5级（T5/5）的时间、在注药后出现言语功能障碍的时间(Tverb)和从注药至语言停止的时间(Tnverb)，并根据患者性别、患侧或健侧、左右侧、语言及记忆优势半球或非优势半球进行对比分析。结果 42例（80侧）进行Wada试验，单侧丙泊酚的用量为7～24（13.8±3.6）mg。顺利完成38例，成功率为90.5%。在成功完成的38例76侧中，有11侧测试时患者出现了不同程度的不良反应，不良反应发生率为14.5%；37例确定语言优势半球，有效率为97.4%；27例确定记忆优势半球，有效率为71.1%。Tverb、Tnverb在左右侧、语言优势半球及非优势半球，记忆优势半球及非优势半球的差异均有统计学意义(P＜0.05)。结论 应用丙泊酚进行Wada试验是相对安全、有效的，基本可以替代异戊巴比妥钠以达到确定语言和记忆优势半球效果。 [关键词] Wada试验；丙泊酚；癫痫 [中图法分类号] [文献标志码] A Clinical analysis of Wada test with propofol as sodium pentobarbital substitute Wu Jiang, Li Wenling, Yue Xiangyong, Zhao Lei, Zhang Bo, Chen Yao, Zheng Jie, Guo Tao, Liang Chuandong, Dong Changzheng, Kang Jinsheng (Department of Functional Neurosurgery, Hebei General Hospital, Shijiazhuang, Hebei, 050051, China) [Abstract] Objective To explore whether propofol can replace sodium pentobarbital in Wada test to determine the language and memory advantage hemispheres. Methods Forty-two cases of Wada test with propofol as sodium pentobarbital substitute were retrospectively analyzed. The success rate and safety were summarized, and the determination effectiveness of language and memory advantage hemispheres was analyzed. Results In Wada test, unilateral dosage of propofol was 7-24 mg ((13.8±3.6) mg in average). Among 42 cases of Wada test, 38 cases were completed smoothly, and the success rate was 90.5%. In the 38 cases, 11 sides of 76 sides of test patients showed different degrees of adverse reactions, and the incidence of adverse reactions was 14.5%. Of the completed 38 cases, 37 cases determined the language advantage hemisphere, with the effective rate of 97.4%, and 27 cases determined the memory advantage hemisphere, with the effective rate of 71.1%. Tverb and Tnerb had sta