重型颅脑损伤后长期意识障碍患者的清醒预测及预后评估

Prediction of Outcome of Awakening and Assessment of Prognoses in Patients with Long-Term Unconsciousness after Severe Traumatic Brain Injury

目的探讨影响重型颅脑损伤后长期意识障碍患者清醒的因素及其对预后预测的价值。方法对46例重型颅脑损伤后意识障碍超过2周的患者进行清醒预测,选择6个预后影响因子即年龄、性别、受伤机制、手术与否、体感诱发电位(SEP)表现方式、清醒所需时间等对预后进行分析,清醒结果以患者伤后6个月是否清醒为标准。预后评估以伤后6个月GOS评分为标准进行判别。结果SEP分级与患者清醒及预后有显著相关性(r=-0.749,P<0.01),分级越高,清醒的几率越小,预后越差。结论SEP的分级可客观、准确地反映颅脑损伤患者的预后和清醒几率。

Objectives To study the factor affecting the awakening and prognosis in the patients with long-term uneonseiousness after severe traumatic brain injury （TBI）. Methods Six factors including age, sex, mechanisms of injury, history of operation, type of somatosensory evoked potentials （SEP） and duration of coma were selected and their relationship with the prognosis were analyzed in 46 patients who lost their consciousness for more than 2 weeks due to severe TBI. The prognoses were assessed by Glasgow Outcome Scale （GOS） 6 months after tbe TBI. Resnlt The type of SEP was significantly related with the awakening and prognoses in the patients with long-term unconsciousness after severe TBI （r---0.749, P〈O.01）. Conclusion The type of SEP is helpful to predict awakening and prognoses in the patients with long-term unconsciousness after severe TBI.