短潜时体感诱发电位对重度颅脑外伤术后昏迷病人的预后评估  

Prognostic evaluation of SSEP for postoperative coma of patients with severe closed head injury.

作　　者：费智敏[1,2] 徐纪文[1,2] 王勇 罗其中[1,2] 金萍茜[1,2] 邱永明[1,2] 李善泉[1,2] 

机构地区：[1]上海第二医科大学附属仁济医院神经外科 [2]上海第二医科大学神经外科研究室

出　　处：《中国神经精神疾病杂志》1998年第1期17-19,共3页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨短潜时体感诱发电位（ＳＳＥＰ）评估重度颅脑外伤术后昏迷病人预后的价值。方法对重度颅脑外伤６０例术后７２小时内行ＳＳＥＰ检查，并比较ＳＳＥＰ分级与格拉斯哥评分（ＧＣＳ）对术后６个月预后的影响。结果预后良好者３８例，预后不良者２２例。如以两侧均测得Ｎ２０波为预后良好的指标，其阳性率为８７％，灵敏度为９２％，特异性为７７％；以一侧或两侧Ｎ２０波缺失为预后不良的指标，则三者分别为８５％、７７％和９２％。结论ＳＳＥＰ可作为一种新的预后评估手段。Objective The aim of study was to investigate prognostic value of SSEP for postoperative coma of patients with severe closed head injury. Methods SSEP were recorded from 60 patients with severe head injury postoperatively. Predictions of outcome were compared between SSEP and GCScore. Results There were 38 cases in good prognosis, 22 in bad prognosis. The bilateral presence of N20 within the initial 72h after operative predicted a favorable outcome with a positive predictive value of 87%, a sensitivity of 92%, and a specificity of 77%. The absence of N20 predicted a unfavorable outcome with a positive predictive value of 85%, a sensitivity of 77%, and a specificity of 92%. Conclusions SSEP was a efficacious method in predictiong the prognosis of severe head injury and the N20 wave was the most important index in addition to GCS. 

关 键 词：颅脑外伤 预后 评估 体感诱发电位 手术后 昏迷 

分 类 号：R651.150.7[医药卫生—外科学]