动态脑电图对皮层或脑干病变昏迷病人预后的评估价值

Comparison of Prognostic Value of Dynamic Electroencephalogram in Comatose Patients with Different Diseased Region

目的观察动态脑电图对皮层或脑干病变昏迷病人预后的评估价值。方法收集45例原发皮层病变和22例原发脑干病变昏迷病人,于急性期行动态脑电图检测和Glasgow评分,随访3个月,将动态脑电图结果与病人的预后进行相关分析。结果两组脑电图异常分级与Glasgow评分均呈负相关;动态脑电图对病人预后评估的敏感性(83.3%)、特异性(100%)和准确率(91.7%)在原发皮层病变组均比脑干病变组高(60.0%,75.0%,75.0%)。结论急性期动态脑电图检测对原发皮层病变昏迷病人预后的评估有确定的价值,但对原发脑干病变昏迷患者的预后评估价值不确定。

Objective To observe prognostic value of dynamic electroencephalogram in comatose patients with primarily cortical and brainstem lesions. Methods The dynamic electioencephalogram and Glasgow Score were examined in 45 comatose patients with primarily cortical lesions and 22 comatose patients with primarily brainstem lesions in acute phase. The patients were followed-up for 3 month. Correlation of dynamic electroencephalogram and Glasgow score with prognosis of patients was analyzed. Results Significant negative correlations were found between the abnormal grade of dynamic electroencephalogram and Glasgow Score both in patients with primarily cortical lesions and primarily brainstem lesions; the sensibility（83.3 % ）, specificity（100 % ） and accuracy（91. 7 % ） that dynamic electroencephalogram predicted the outcome of comatose patients with primarily cortical lesions were higher than those with primarily brainstem lesions （60.0%, 75.0 %, 75.0 % ）. Conclusion Dynamic electroencephalogram was valuable in prediction of the outcome of comatose patients with primarily cortical lesions and was not certainly in primarily brainstem lesions.