早期短潜伏期体感诱发电位在高血压性小脑出血预后评估中的作用  

Role of early short-latency somatosensory evoked potentials in prognostic evaluation of patients with hypertensive cerebellar hemorrhage after operation

作　　者：满明昊 李立宏 李敏 田博 郭少春 马涛 鲁华山 MAN Ming-hao;LI Li-hong;LI Min;TIAN Bo;GUO Shao-chun;MA Tao;LU Hua-hsna(Department of Neurosurgery,Tangdu Hospital,Air Force Medical University,710038 Xi'an,China;Department of Emergency,Tangdu Hospital,Air Force Medical University,710038 Xi'an,China)

机构地区：[1]空军军医大学唐都医院神经外科,西安710038 [2]空军军医大学唐都医院急诊科,西安710038

出　　处：《中国临床神经外科杂志》2021年第4期240-242,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨高血压性小脑出血病人术后1周内短潜伏期体感诱发电位(SSEP)与预后的相关性。方法回顾性分析2016年1月至2018年12月手术治疗的63例高血压性小脑出血的临床资料。术后1周内使用正中神经电刺激监测SSEP,分析N13、N20波形分级,5~6级为波形分级良好。术后1个月采用GCS评分评估意识情况;术后6个月采用改良Rankin量表(mRS)评分及GOS评分评估预后,GOS评分4~5分、mRS评分0~2分为预后良好。结果N13、N20分级与术后1个月GCS评分呈正相关(r分别为0.810、0.687;P<0.05),与术后6个月GOS评分呈正相关(r分别为0.474、0.322;P<0.05)、mRS评分呈负相关(r分别为-0.577、-0.444;P<0.05)。N13、N20分级良好与术后6个月预后良好呈明显正相关(r分别为0.414、0.247;P<0.05)。N13、N20分级良好预测术后6个月预后良好的阳性率为65.0%、55.6%。结论相较于GCS评分,高血压性小脑出血术后1周内SSEP检测N13、N20分级,有更好的预后评估价值。Objective To explore the value of the early short-latency somatosensory evoked potentials(SSEP)in evaluating the prognoses of patients with hypertensive cerebellar hemorrhage(HCH)after the surgery.Methods The clinical data of 63 patients with HCH who underwent surgery from January 2016 to December 2018 were anlyzed retrospectively.The SSEP was performed on all the patients within 1 week after the operation,and the N13 and N20 potentials were analyzed with grade 5~6 of good grading.The GCS score was used to assess the conscious state 1 month after the operation.The mRS and GOS scores were used to assess the prognosis,with GOS score 4~5 or mRS score 0~2 of good pronosis.Results The N13 and N20 potential gradings were positively significantly correlated with the 1-month GCS score(r=0.810 and r=0.687,respectively;P<0.05)and the 6-month GOS score(r=0.474 and r=0.444,respectively;P<0.05),and negtively significantly correlated with the 6-month mRS score(r=-0.577 and r=-0.444,respectively;P<0.05).Good grades of N13 and N20 potential were significantly positively correlated with the good prgnosis(r=0.414,r=0.247,respectively;P<0.05).The positive rates of good grade of N13 and N20 for pridicting the good prognosis were 65.0%and 55.6%,respectively.Conclusions Compared with the GCS score,the N13 and N20 potentials of SEEP within 1 week after the operation has better prognostic evaluation value for the patients with HCH.

关 键 词：高血压性脑出血 小脑出血 短潜伏期体感诱发电位 预后评估 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]