躯体感觉诱发电位在弥漫性轴索损伤中的应用

The application of somatosensory evoked potentials in diffuse axonal injury

目的探讨躯体感觉诱发电位(SEP)对弥漫性轴索损伤(DAI)伤情判断及预后评估价值。方法对39例DAI患者(观察组)和31例健康志愿者(对照组)进行SEP动态检查,观察及比较两组SEP各波的变化。结果观察组SEP总异常率为66.67%,两组间N20波的PL及N13～N20的IPL值比较差异有统计学意义(<0.01)。SEP分级与GCS、GOS均呈负相关(=-0.5026、-0.5490,P<0.01)。结论SEP可从电生理角度评价大脑的功能状态,有助于临床对DAI患者脑功能和预后的评估和判断。

Objective To investigate the value of somatosensory evoked potentials （SEP） in evaluating the severiry and predicting prognosis of diffuse axonal injury （DAI）. Methods Serial SEP recordings were obtained from 39 patients with DAI. The first SEP was recorded on admission, followed by repeated recordings when clinical condition of patients was deteriorated or/and 1 day before patients were discharged. SEP findings of patients were compared with those in the control group and analyzed by t test.The correlation between SEP grade and GCS, GOS was analyzed. Results （1） In our study, the number of patients with normal SEP, wave latency prolongation, N20 wave disappearance was 13, 18 and 8 respectively. The total abnormal rate of SEP was 66.67%. The differences of the PL of N20 and the IPL of N 13-N20 between the abnormal group and the control group were statistically significant. （2） The correlation between SEP grade and GCS was significant, and the correlation coefficient was -0.5026. The correlation between SEP grade and GOS was also significant, and the correlation coefficient was -0.5490. The higher the SEP grade was, the severer the patient＇ s condition was. and the poorer the prognosis was. Conclusion SEP can evaluate the function status of brain, monitor the patients＇ condition, evaluate the effect and judge the prognosis of the patients. SEP is the subjective index to evaluate the brain function and the prognosis of patients with DAI.