急性大面积脑梗死的脑电图RAWOD模式的应用价值  

Study on special pattern of the EEG-RAWOD of acute massive ischemic infarction

作　　者：杨庆林[1] 宿英英[1] 

机构地区：[1]首都医科大学北京宣武医院神经内科

出　　处：《中华神经科杂志》2007年第1期8-10,共3页Chinese Journal of Neurology

基　　金：北京市科委科研基金(953304003)

摘　　要：目的探讨脑电图 RAWOD 模式对早期大面积脑梗死的临床应用价值。方法对47例发病7 d 内的大面积脑梗死患者进行脑电图、美国国立卫生院卒中评分(NIHSS)和格拉斯哥昏迷评分(GCS)评估。结果 47例患者共行脑电图监测70例次,脑电图 RAWOD 模式的出现率为68.1%;发病24 h 内的 RAWOD 模式出现率为76.9%,而 CT 阳性率为28.6%;脑梗死面积越大RAWOD 模式出现率越高。RAWOD 模式组 GCS 高于非 RAWOD 模式组,NIHSS 评分低于非 RAWOD模式组,差异有统计学意义(P<0.05)。RAWOD 模式组脑疝发生率和病死率高于非 RAWOD 模式组(JP<0.05)。结论脑电图显示的 RAWOD 模式是大面积脑梗死的特殊表现形式,发病早期具有诊断价值,特别在未得到影像学证实时尤为重要;并可作为预后预测的可靠指标。Objectives To study a special pattern of electroencephalogram （EEG）, regional attenuation without Delta in massive cerebral ischemic infraction and evaluate its clinical value. Methods All the 47 cases diagnosed as massive cerebral infraction were continuously observed and evaluated in the period of 2004 to 2006 for EEG, short-latency somatosensory evoked potential （SLSEP）. Glasgow coma scale （GCS） and the National Institutes of Health Stroke Scale （NIHSS） were also rated. EEG monitoring was performed every 1 to 3 day, but at least one time for patient with deteriorated condition. The outcome was evaluated with Glasgow outcome scale （GOS）. Results 47 cases were performed 70 times of EEG all together, among whom 32 cases （ 68. 1% ） showed RAWOD in EEG. The positive rate of RAWOD was 76. 9% within 24 hours of onset, but it was 28.6% in CT in the same time. The GCS and NIHSS of two groups had significant differences（P 〈 0. 05）. The larger the area of infarction,the higher the positive rate of RAWOD. The mortality and incidence of cerebral hernia in RAWOD group was higher than the group without RAWOD （P 〈 0. 05 ）. Condusions RAWOD on EEG is a special pattern for early acute cerebral infarction within 24 hours of onset, which is an important index in predicting the prognosis,especially when there is no imaging proof.

关 键 词：脑电描记术 诱发电位 躯体感觉 脑梗塞 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]