动态脑电图、诱发电位判断脑血管病昏迷患者的预后  

The value of EEG,SEP and BAEP in evaluation of the outcome in stroke patients with coma

作　　者：樊双义[1] 魏洪林[1] 王菁[2] 刘淑艳[2] 王天昊[1] 马朋林[1] 冷凯利[1] 

机构地区：[1]解放军总医院第二附属医院急救部,北京100091 [2]解放军总医院第二附属医院神经电生理室,北京100091

出　　处：《临床神经电生理学杂志》2009年第1期13-17,共5页Journal of Clinical Electroneurophysiology

摘　　要：目的：评价动态脑电图（EEG）、体感诱发电位（SEP）、脑干听觉诱发电位（BAEP）三种神经电生理检查在脑血管病昏迷患者预后判断中的作用。方法：对急性脑卒中致昏迷65例患者进行EEG、SEP、BAEP检查。EEG按Young标准分为Ⅰ—Ⅴ级；BAEP分析Ⅰ、Ⅲ、Ⅴ波各波潜伏期、峰间期及双侧波幅差，结果按Cant标准分为Ⅰ-Ⅲ级；SEP分析N20波，结果也分为Ⅰ-Ⅲ级。预后分为清醒、持续植物状态和死亡三种情况。结果：65例患者，EEG、BAEP、SEP均为Ⅰ级的15例患者中，死亡3例，持续植物状态2例，清醒10例；EEG、BAEP、SEP均为Ⅱ级的13例患者中，死亡5例，持续植物状态2例，清醒6例；属EEGⅢ级及其以上、BAEP及SEPⅢ级的37例患者中，死亡24例，持续植物状态9例，清醒仅4例。结论：EEG、BAEP和SEP的分级高低（异常程度）与昏迷患者的预后有密切关系，分级越高病死率越高。EEG、BAEP和SEP相结合，可以提高判断脑血管病昏迷患者预后的准确性。Objective： To evaluate the value of ambulatory electroencephalogram （EEG）, somatosensory evoked potentials （SEP） and brainstem auditory evoked potentials（BAEP） in prediction of the outcome in patients with coma resulted from cerebrovascular diseases. Methods： Ambulatory EEG, SEP and BAEP were examined in 65 patients with coma caused by cerebrovascular diseases. The consequence was analysed. The EEG result was defined as Level Ⅰ- Ⅴ , SEP and BAEP results were defined as Level Ⅰ -Ⅲ. The endpoints for outcome were graded as conscious state, continuous vegetational state and death. Results： Ten of 65 cases belonged to Level Ⅰ of EEG, SEP and BAEP,in which 8 recovered well, 1 death and 1 in continuous vegetational state. Egihteen of 65 cases belonged to Level Ⅱ of EEG, SEP and BAEP,in which 8 death and 4 in continuous vegetational state and 6 recovered well. However, among 37 of 65 eases with of EEG, SEP and BAEP higher than Level Ⅱ , 30 cases died,5 were in continuous vegetational state and 2 recovered well. Conclusion： A close relationship between bad outcome and high level of EEG, SEP and BAEP was found in patients with coma caused by cerebrovascular diseases. It could improve the veracity in evaluation of the outcome in stroke patients with coma to use EEG, SEP and BAEP monitoring.

关 键 词：脑电图 诱发电位 脑血管病 昏迷 预后 

分 类 号：R741.044[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学]