Application Of Different Early Warning Criteria Of TES-MEPs Monitoring In Tumor Surgery Near Motor Area

Objective:To investigate the relationship between motor evoked potential(MEP)monitoring and limb muscle strength decline in patients with motor area and its adjacent tumors,using transcranial Electrical stimulation(TES)and motor evoked potential(MEP)monitoring.To further explore the value of intraoperative TES-MEPs monitoring in tumor surgery near motor area.Methods: From January 2017 to February 2018,a prospective study was conducted in the motor area and its adjacent area of tumors in the neurosurgery department of the first people's Hospital of Changde City.TES-MEPs monitoring and neuronavigation were used in all cases.According to the different early warning criteria of TES-MEPs monitoring,the cases were divided into "amplitude group","incubation period group" and "combination group".The distribution of age,sex,tumor size,resection degree and other variables in each group were observed.The sensitivity and specificity of each early warning criterion were calculated by statistical method,and the results were tested by regression analysis of different warning criteria and muscle strength change.Results:A total of 48 samples were included in this study.The age,sex and tumor size of the three groups were studied.The sensitivity(true positive rate)of the combined group was the highest(81.2% after operation,78.6% after discharge,P < 0.05),and the specificity of latency group(true negative group)was calculated by c2 test,and the distribution of clinical data such as resection degree was no significant difference among subgroups(p < 0.05).,and the sensitivity(true positive rate)of the combined group was the highest(81.2% after operation),and 78.6%(p < 0.05).when discharged from hospital.The result of regression analysis showed that the regression coefficient of postoperative wave latency group was the largest,?-See was 24.1(p < 0.05).,and that of combination group was the largest at discharge,and ?-See was 10.1(p < 0.05).The results showed that the regression coefficient was lower than 0.05 in the group of postoperative latency and the group of ? seg(p < 0.05),and the regression coefficient was the highest at the time of discharge(p < 0.05),and the regression coefficient was the highest(p < 0.05).Conclusion:1)The experiment confirmed that the "amplitude decrease of more than 50%" in TES-MEPs monitoring,and the incubation period longer than 10% is an effective warning standard,but its diagnostic ability has its own advantages and disadvantages.2)during the operation of the tumor in the cerebral motor area and its adjacent region,when the TES-MEPs monitoring was performed,the sensitivity of the combined use of the two warning standards of "amplitude decline more than 50%" and "prolonged latency longer than 10%" was higher,and it was more suitable to exclude the decline of muscle strength after the operation,and the "incubation period of longer than 10%" was used alone.This alarm standard is more specific and more suitable for predicting muscle strength decline after surgery.