多模式电生理监测对急性脑血管病早期昏迷预后的预测价值  

Predictive value of multi-mode electrophysiological monitoring in the early coma of acute cerebrovascular disease

作　　者：程启燕 黄羽[1] CHENG Qiyan;HUANG Yu(Department of Neurology ,Chongqing Sanxia Central Hospital ,Chongqing (404199),China)

机构地区：[1]重庆三峡中心医院,重庆404199

出　　处：《癫痫与神经电生理学杂志》2019年第5期297-300,304,共5页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的:探讨多模式电生理监测技术对急性脑血管病早期昏迷患者预后的预测价值。方法:对急性脑血管病早期昏迷患者72例24 h内行脑电图(EEG)、正中神经短潜伏时体感诱发电位(SSEP)、脑干听觉诱发电位(BAEP)、经颅多普勒(TCD)监测,3个月时行格拉斯哥昏迷预后(GOS)评分为观察终点,比较各项神经电生理监测技术对预后不良的敏感性及特异性。结果:EEG对急性脑血管病预后不良的特异性是73%,敏感性是54%,SSEP的特异性是93%,敏感性是63%,EAEP的特异性是60%,敏感性是21%,TCD的特异性是100%,敏感性是14%。结论:SSEP的敏感性和特异性均较高,有较好的预测价值,早期多模式电生理监测的联合使用可评估急性脑血管病昏迷患者的神经功能,指导临床决策、评估不良预后。Objective: To investigate the predictive value of multi-mode electrophysiological monitoring in the early coma of acute cerebrovascular disease. Methods: Electroencephalography (EEG), median nerve short latency somatosensory evoked potential(SSEP), brainstem auditory evoked potential( BAEP)and transcranial doppler(TCD) were detected within 24 hours for coma patients with acute cerebrovascular disease. Results: The specificity of EEG for poor prognosis for coma patients with acute cerebrovascular disease was 54. 4%, the sensitivity was 54. 4%. The specificity of SSEP was 93. 3%, the sensitivity was 63. 2%. The specificity of BAEP was 60%, the sensitivity was 21. 1 %, The specificity of TCD was 100%, the sensitivity was 14%. Conclusion: SSEP possesses higher specificity and sensitivity and good predictive value. In the early stage of acute cerebrovascular disease, mult-mode combination detected neurological function can guide clinical decision-making and evaluate poor prognosis.

关 键 词：昏迷 脑血管病 脑干听觉诱发电位(BAEP) 体感诱发电位(SEP) 脑电图(EEG) 经颅多普勒(TCD) 

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]