中毒性昏迷患者脑电图模式及动态监测对预后的探讨

The analysis of video EEG and MRI results in patients of complex partial seisures

目的探讨脑电图模式及动态监测对中毒性昏迷患者的应用价值。方法回顾性研究119例中毒性昏迷患者临床资料及不同时间段的长程脑电图模式。结果脑电监测显示除安定中毒以B昏迷为主外，其余各类中毒性昏迷患者均以弥漫性慢波异常的Ⅴ型脑电构型多见；预后方面脑电构型Ⅰ型全部预后不良，Ⅱ型及Ⅲ型预后不良率为81．8％及60．0％，Ⅴ型预后最好，不良率仅为2．9％；复查时脑电显示改善者临床预后良好，而脑电恶化者临床预后不良。结论中毒性昏迷者的脑电图构型对判断昏迷程度和预后有一定意义，而对昏迷病人进行长程脑电动态监测，能为预詹判断提供动态和更为准确的信息。

Objective To explore the application value of electroencephalograph （EEG） patterns and dynamic monitoring in toxic comatose survivors.Methods Retrospective research of clinical data and different time intervals of long term EEG patterns according to 119 toxic comatose survivors.Results EEG monitoring indicated that all kinds of toxic comatose survivors were almost diffused slow waves of V style EEG pattern, except for those valium intoxation cataphora which were mainly 13 style. All Ⅰ style EEG pattern had an unfavorable prognosis, style Ⅱ and style Ⅲ had an unfavorable prognosis rate of 81.8 percents and 60 percents, while the best one was Ⅴ style EEG pattern which had an abnormal diffused slow waves and 2.9 percents of unfavorable prognosis rate. The patients whose EEG pattern indicated a better trend during re-inspection predicted favorable prognosis, while a worse trend predicted unfavorable prognosis.Conclusions The EEG pattern of toxic comatose survivors has some sense to judging comatose degree and prognosis. However for those comatose patients, long term dynamic EEG monitoring can provide dynamic and more precise information for prognosis judgment.