体感诱发电位和脑电图对非外伤性昏迷患儿预后的判断价值  

Value of somatosensory evoked potential and electroencephalography to estimate prognosis of non-traumatic comatose children

作　　者：兰兴会[1] 张琴[1] 冯成功[1] 王莉[1] 徐娜[1] 

机构地区：[1]重庆医科大学儿童医院神经电生理室,重庆400014

出　　处：《临床神经电生理学杂志》2007年第2期78-80,共3页Journal of Clinical Electroneurophysiology

摘　　要：目的:探讨体感诱发电位(SEP)和脑电图(EEG)检测在非外伤性昏迷患儿预后评估中的价值。方法:对26例昏迷患儿[格拉斯哥昏迷量表(GCS)评分≤8分]早期进行双侧正中神经的SEP检测和EEG检查,随访6个月后进行预后分析。结果:①26例昏迷患儿SEP 11例正常,15例(58%)异常,SEP的异常均表现为皮层电位N20异常,其中6例皮层N20波缺失;26例患儿EEG结果均为异常,其中5例为背景活动低电压,1例为弥慢性θ活动,20例为弥漫性δ慢活动;②SEP正常的11例中,9例预后良好,2例(18%)预后不良,SEP异常的15例中,14例(93%)预后不良,其中6例死亡,5例EEG为背景活动低电压患儿的SEP均严重异常,预后最差。结论:①早期对非外伤性昏迷患儿的预后判断SEP优于EEC;②SEP皮层电位N20波缺失,同时EEG为背景活动低电压患儿,预后最差;③SEP对非外伤性昏迷患儿在早期判断预后是一种客观、有效方法,有着重要的临床应用价值。Objective：To explore the value of somatosensory evoked potentials（SEPs） and electroencephalogram（EEG） in the prognosis of comatose children. Methods： Twenty-six comatose children [Glasgow coma score（GCS）≤8]was examined by SEPs（in their median nerve） and EEG in the early state. They had been followed up for six months to analyse their prognosis . Results： 1） Of the children with coma, SEPs were normal in 11 cases and abnormal in other 15 cases including 6 cases with the lack of N20. All the patients showed abnormal EEG background activation, including low voltage in 5 cases and diffuse 8 activation iN20 cases. （2）Nine cases had a benign prognosis among 11 patients with normal SEP and 14 had an unfavorable outcome, including 6 patients died among 15 patients with abnormal SEPs. Of the patients with low voltage background EEG and lack of N20 of SEP, 5 cases had the worst prognosis . Conclusions： （1）The SEP is superior to the EEG for evaluating the prognosis of comatose patients in the early stage;（2）There is the most unfavorable outcome in patients with the low voltage background activation on the EEG and lack of SEP N20 ;（3）SEP is an objective and valuable method to estimate the prognosis of comatose patients in the early period.

关 键 词：儿童 体感诱发电位(SEP) 脑电图(EEG) 昏迷 预后 

分 类 号：R741.044[医药卫生—神经病学与精神病学] R651.15[医药卫生—临床医学]