连续脑电图监测对重症脑出血脑功能损伤的评价

Role of continuous electroencephalography monitoring in assessing patients with critical cerebral hemorrhage

目的:探讨连续脑电图(CEEG)监测对重症脑出血患者脑功能损伤评价和预后判断的应用价值。方法:对格拉斯哥昏迷评分≤8分的急性重症脑出血患者30例进行床边中央神经监护系统记录CEEG,按Young分级标准分级判断,随访患者2个月的预后,将CEEG分级与预后进行相关分析。结果:30例重症脑出血患者的CEEG全部异常,发生癫痫样活动者4例,其中非痉挛性癫痫发生率为10%,痉挛性癫痫的发生率为3.3%。CEEGⅠ～Ⅱ级者预后不良率为11.8%,CEEGⅢ～Ⅵ级预后不良率达53.8%,差异有统计学意义(P=0.019)。结论:CEEG和分级结果与预后显著相关,可以准确、客观地评价和预测神经科重症脑出血患者脑功能损伤的预后。

Objective：To evaluate continuous electroencephalography（CEEG） monitoring in assessing and predicting the prognosis of patients with critical cerebral hemorrhage.Methods：CEEG′s classification was dynamically recorded at the bedside of 30 cases of critical cerebral hemorrhage with Glasgow coma scale≤8.The outcome was evaluated cording to the Young criteria.All the patients were followed up for 2 months,and the correlation between the results of CEEG′s monitoring and the prognosis of the patients was analyzed.Results：The CEEG of 30 patients with critical cerebral hemorrhage was nearly always markedly abnormal.The occurrence of nonconvulsive seizures was observed in 10% of the patients and convulsive seizures in 3.3%.The unfavorable prognosis rate in the cases with CEEG classification of Ⅰ and Ⅱ was 11.8%,while it was 53.8% in cases with CEEG classification of Ⅲ-Ⅵ.The difference was significant（P=0.019）.Conclusions：The CEEG classification is markedly correlated with the prognosis of patients with acute critical cerebral hemorrhage,and CEEG monitoring might be of certain value in predicting the outcome.