脑干听觉诱发电位联合中脑形态对重型颅脑损伤昏迷患者预后评估的临床研究  

Clinical study of prognosis evaluation of bralnstem auditory evoked potential combined with mesencephalic morphology on coma patients with severe craniocerebral injury

作　　者：王磊[1] 黄富[1] 张清华[1] 赵振林[1] 胡栋[1] 肖华[1] 

机构地区：[1]南方医科大学附属花都医院神经外科,广州510800

出　　处：《中国医师进修杂志》2012年第17期1-4,共4页Chinese Journal of Postgraduates of Medicine

基　　金：广州市医药卫生科技项目（201102A212027）

摘　　要：目的：探讨脑干听觉诱发电位（BAEP）联合中脑形态与重型颅脑损伤昏迷患者临床预后的关系。方法对47例重型颅脑损伤昏迷患者早期行BAEP检查并行动态监测，同时行头颅CT扫描并测量中脑前后径与横径比值。结果47例患者首次BAEP分级与随访结束时格拉斯哥预后量表（GOS）评分呈负相关（r=-0．755，P=0．000）。47例患者中27例中脑前后径与横径比值为0．9-1．1，预后良好19例（70．4％，19／27）；20例患者中脑前后径与横径比值〉1．1或〈0．9，预后良好6例（30．0％，6／20），两者预后良好率比较差异有统计学意义（χ^2=7．521，P=0．006）。首次BAEP联合头颅CT检查的敏感度、特异度分别为73．7％（14／19）、82．6％（19／23），第2次BAEP联合头颅CT检查的敏感度、特异度分别为88．2％（15／17）、100．0％（21／21）。结论BAEP联合中脑形态可有效评估重型颅脑损伤昏迷患者的预后。Objective To explore the correlation between brainstem auditory evoked potential （BAEP） combined with mesencephalic morphology and the prognosis of coma patients with severe craniocerebral injury. Methods Forty-seven coma patients with severe craniocerebral injury were examined with BAEP and monitored dynamically in early period of coma, and all these patients got bead CT scans and the ratio of anteroposterior diameter and transverse diameter of mesencephalon were measured at the same time. Results There was a significantly negative relationship between the first BAEP classification and GOS score at the end of the follow-up （r = -0.755 ,P = 0.000）. Among all of the patients,there were 27 patients with the ratio of anteroposterior diameter and transverse diameter of mesencephalon from 0.9 to 1.1,19 patients （70.4%, 19/27） with good prognosis;20 patients with the ratio 〉1.1 or 〈 0.9,6 patients （30.0%, 6/20） with good prognosis. The rate of good prognosis between the two had significant difference （χ^2 = 7.521, P = 0.006）. The sensitivity and specificity were 73.7% （14/19）, 82.6% （ 19/23 ） at the first BAEP combined with mesencephalic morphology,88.2% （15/17）,100.0% （21/21） at the second BAEP combined with mesencephalic morphology. Conclusion BAEP combined with mesencephalic morphology can evaluate effectively the prognosis of coma patients with severe craniocerebral injury.

关 键 词：诱发电位 听觉 脑干 体层摄影术 X线计算机 颅脑损伤 预后 

分 类 号：R651.1[医药卫生—外科学]