迷走神经刺激术视频：迷走神经刺激术治疗药物难治性癫痫
Topic: Vagus nerve stimulation for treatment of drug-resistant epilepsy
作者：刘强强，徐纪文，周洪语，叶晓来，赵晨杰，马军峰
Authors: LIU Qiang-qiang, XU Ji-wen, ZHOU Hong-yu, YE Xiao-lai, ZHAO Chen-jie, MA Jun-feng
原文链接：中国现代神经疾病杂志,2015,15(9):722-726
Associated with: Chinese Journal of Contemporary Neurology and Neurosurgery, 2015, 15(9):722-726
摘要：患者麻醉满意后，暴露左侧颈动脉鞘，它一般沿胸锁乳突肌的前缘延伸。迷走神经通常位于颈动脉和颈内静脉之间的后侧。
找到并剥离左迷走神经主干至少3cm。推荐将这3cm主干中的上半部分设计在胸锁乳突肌后方，因为该段迷走神经的分支较清楚。注意不能将刺激电极放在迷走神经心脏上分支和下分支。在手术过程中使用硅胶条来分离迷走神经主干可以事半功倍。
将两个刺激电极和一个固定电极缠绕完毕后，可以将导线环绕形成一个3cm的袢，这样可以缓解颈部运动时的张力。同时将这个袢用垫片固定于周围筋膜组织。
在胸大肌和胸小肌的筋膜间形成一个放置脉冲发射器的腔隙。用皮下通条将颈部切口的导线引到胸部切口器。导线连接端必须完全插入脉冲发生器头。证实导线连接端完全插入后，用六角螺丝刀将固定螺丝沿顺时针方向旋动拧紧，直到出现“滴答”声。
导线和脉冲发生器相连接后，必须进行系统刺激测试。
Introduction: After administering appropriate anesthesia to the patient, expose the left carotid sheath as it extends along the anterior border of the sternocleidomastoid muscle. The nerve usually lies in a posterior groove between the carotid artery and internal jugular vein.
Locate and expose at least 3 centimeters of the left vagus nerve. The recommended stimulation site is a 3-cm section of the vagus nerve, approximately half-way up between the clavicle and the mastoid process, where it is clear of branches. The Lead electrodes must not be placed on either the superior or the inferior cervical cardiac branches.
A silicone sheet may be useful to separate the nerve from tissue during the procedure.
After attaching the two electrodes and the anchor tether, form a 3-cm strain relief bend and a strain relief loop in the Lead to provide adequate slack and allow for neck movement.
Loosely attach the 3-cm strain relief bend to the adjacent fascia with tie-downs.
Create a pocket in the chest between the superior and inferior pectoralis fascia for the Pulse Generator.
The tunneler is used to tunnel the Lead connector and Lead body subcutaneously from the neck incision site to the Pulse Generator in the chest pocket.
Lead connector pin must be inserted fully into the Pulse Generator header.
Topic: Vagus nerve stimulation for treatment of drug-resistant epilepsy
作者：刘强强，徐纪文，周洪语，叶晓来，赵晨杰，马军峰
Authors: LIU Qiang-qiang, XU Ji-wen, ZHOU Hong-yu, YE Xiao-lai, ZHAO Chen-jie, MA Jun-feng
原文链接：中国现代神经疾病杂志,2015,15(9):722-726
Associated with: Chinese Journal of Contemporary Neurology and Neurosurgery, 2015, 15(9):722-726
摘要：患者麻醉满意后，暴露左侧颈动脉鞘，它一般沿胸锁乳突肌的前缘延伸。迷走神经通常位于颈动脉和颈内静脉之间的后侧。
找到并剥离左迷走神经主干至少3cm。推荐将这3cm主干中的上半部分设计在胸锁乳突肌后方，因为该段迷走神经的分支较清楚。注意不能将刺激电极放在迷走神经心脏上分支和下分支。在手术过程中使用硅胶条来分离迷走神经主干可以事半功倍。
将两个刺激电极和一个固定电极缠绕完毕后，可以将导线环绕形成一个3cm的袢，这样可以缓解颈部运动时的张力。同时将这个袢用垫片固定于周围筋膜组织。
在胸大肌和胸小肌的筋膜间形成一个放置脉冲发射器的腔隙。用皮下通条将颈部切口的导线引到胸部切口器。导线连接端必须完全插入脉冲发生器头。证实导线连接端完全插入后，用六角螺丝刀将固定螺丝沿顺时针方向旋动拧紧，直到出现“滴答”声。
导线和脉冲发生器相连接后，必须进行系统刺激测试。
Introduction: After administering appropriate anesthesia to the patient, expose the left carotid sheath as it extends along the anterior border of the sternocleidomastoid muscle. The nerve usually lies in a posterior groove between the carotid artery and internal jugular vein.
Locate and expose at least 3 centimeters of the left vagus nerve. The recommended stimulation site is a 3-cm section of the vagus nerve, approximately half-way up between the clavicle and the mastoid process, where it is clear of branches. The Lead electrodes must not be placed on either the superior or the inferior cervical cardiac branches.
A silicone sheet may be useful to separate the nerve from tissue during the procedure.
After attaching the two electrodes and the anchor tether, form a 3-cm strain relief bend and a strain relief loop in the Lead to provide adequate slack and allow for neck movement.
Loosely attach the 3-cm strain relief bend to the adjacent fascia with tie-downs.
Create a pocket in the chest between the superior and inferior pectoralis fascia for the Pulse Generator.
The tunneler is used to tunnel the Lead connector and Lead body subcutaneously from the neck incision site to the Pulse Generator in the chest pocket.
Lead connector pin must be inserted fully into the Pulse Generator header.
ISSN: 1672-6731