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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
Objective: To study the monitoring value of binaural stimulation and bilaterally recorded brainstem auditory evoked potential in brain stem tumor surgery. Methods: Thirty healthy subjects with normal hearing were tested with binaural stimulation, bilateral recordings, monaural stimulation, and ipsilateral recordings. Brainstem auditory evoked potentials were measured in 16 patients with brainstem tumors. Brain stem auditory evoked potentials recorded bilaterally were monitored continuously during the operation. RESULTS: All patients showed BAEPs changes during surgery, and the changes were roughly classified into mild, moderate, and severe changes. Those with mild or moderate changes have good clinical effects; those with severe changes have poor prognosis and even death. CONCLUSIONS: BAEPs recorded bilaterally by bilateral stimulation are more suitable for monitoring during surgery; the degree of BAEPs changes during surgery can reflect the degree of brain stem function affected and predict prognosis; PL, I-III, I of III and/or V waves. Prolongation of IPL of -V or III-V over 1.5 ms or disappearance of all waveforms is a specific indicator of irreversible damage to brain stem function