冷热水刺激的脑电反应对心肺复苏后昏迷患者预后的评估  

Prognostic Value of Video-electroencephalography Reaction to Hot-cold Water Stimulation in Comatose Patients after Cardiopulmonary Resuscitation

作　　者：邱建敏 游学炼 刘丽青 吴永胜 何荔苍[2] 黄元新[2] 

机构地区：[1]福建省莆田市第一医院神经内科,351100 [2]福建省莆田市急救中心

出　　处：《中国全科医学》2017年第A02期45-47,共3页Chinese General Practice

基　　金：福建省莆田市科技计划项目(2013JS01)

摘　　要：目的用视频脑电图(VEEG)对心肺复苏后昏迷患者进行检测,研究冷热水刺激的脑电反应(VEEG-Reaction)对预后的评估价值。方法选择2013年2月—2016年10月莆田市第一医院ICU病房或相关科室住院的心肺复苏后昏迷患者28例,19例死亡,9例生存。患者均根据VEEG监测和冷热水刺激的VEEG-Reaction,格拉斯哥昏迷评分(GCS)和急性生理与慢性生理健康状况评分(APACHEⅡ)进行预后评估,以临床随访结果为金标准,分析3种预后评估方法的判别价值。结果 3种评估方法在全组均有良好的预测价值,VEEG-Reaction预测最佳;冷热水刺激的VEEG-Reaction对心肺复苏后昏迷患者预后评估的灵敏度和特异度均高于GCS和APACHEⅡ评分,与随访结果具有较高的一致性;比较受试者工作特征曲线(ROC)下面积提示VEEG-Reaction(0.82)优于APACHEⅡ(0.78)、GCS(0.72)。结论冷热水刺激的VEEG-Reaction能够较为准确地评估心肺复苏后昏迷患者预后,评估结果与随访结果具有较高的一致性,具有较高的临床应用价值。Objective To investigate the value of video-electroencephalography（ VEEG） reaction to thermal stimulation on evaluating the prognosis of comatose patients after cardiopulmonary resuscitation. Methods 28 comatose patients with cardiopulmonary resuscitation cured in ICU or relative division of the First Hospital of Putian Municipality from February 2013 to Octorber 2016 were selected,19 cases died,9 cases survived. All patients were made prognosis evaluation according to the VEEG reaction to thermal stimulus,GCS and APACHE Ⅱ score,and the clinical value of three kinds of prognosis evaluation methods were analyzed. The result of clinical follow up was set as gold criteria. Results The three modules all had a good predicting the number of prognosis for the whole group,the best group of VEEG-Reaction; the sensitivity and specificity of VEEG reaction to hot-cold water stimulation in evaluating prognosis of patients with cardiopulmonary resuscitation which were higher than those of GCS and APACHEⅡ score,comparisons of the the area under the receiver operating characteristic（ ROC）curve showed that VEEG-reaction（ 0. 82） was superior to APACHE Ⅱ（ 0. 78） and GCS（ 0. 72）, and had follow-up results. Conclusion The Hot-cold water stimulation to VEEG reaction had more accurate assessment on cardiopulmonary resuscitation prognosis,and evaluation results had high consistency with follow-up results,and had high clinical application value.

关 键 词：心肺复苏术 脑电描记术 昏迷 预后 

分 类 号：R654.1[医药卫生—外科学]