急性脑梗死超早期溶栓治疗脑电图动态监测分析(附10例报告)

Analysis of EEG ambulatorily monitoring on acute cerebral infarction treated by thrombolysis in hyperacute time:Report of 10 cases

目的 :探讨急性脑梗死溶栓治疗脑电图改变。方法 :采用 SW- JH2 0 0 0 AR智能化脑电监护仪 ,对 10例急性脑梗死(发病 <6 h)患者溶栓治疗前中后同步进行脑电图动态监测 ,按冯应琨《临床脑电图学》的诊断标准进行分析。结果 :脑电图 (EEG)反应溶栓过程中随溶栓剂用量增加有经时变化之特征 ,静注 5 0万 u尿激酶 (天普洛欣 ) ,慢波明显增多 ,频率变慢 ,定位更明确 ,追加静点 10 0万 u后 ,慢波减少频率增快。 8例患者随 EEG改变 ,肌力恢复显著 ,2例肌力恢复差者复查头颅 CT为大面积脑梗死 ,EEG表现慢波减少 ,1例呈各导联 α波增强 ,1例 θ波明显增多。结论 :(1)急性脑梗死超早期脑电图的异常程度对选择溶栓治疗有指导意义 ;(2 )超早期溶栓治疗同步行脑电图动态监测对患者近期病情演变及预后可作出初步判断。

Objectives:To explore EEG changes of acute infarction treated by thrombolysis.Methods:EEG ambulatorily were monitored in 10 patients with acute cerebral infarction (attacking time<6 hours) by SW JH 2000 AR intelligentized electroencephalogical monitor instrument.The EEG changes before,after and in the process of thrombolysis were analyzed by diagnostic standard of clinical electroencephalogy written by Fong Yingkun.Results:EEG changes reflected this characteristics that brain waves changed with increasement of thrombolysis concentrations.Slow waves increased,frequency became slow,and localization was more definite after introvenously injecting 0.5 million unit urokinase (UK).In the process of thrombolysis,slow waves decreased and frequency increased after introvenously perfusing one million unit UK more.Myodynamia of 8 among these 10 patients recovered remarkedly with improvement of EEG changes.2 among 10 patients whose myodynamia recovered poorly had CT examination,whose CT results showed large size cerebral infarction,and EEG showed slow waves decreasing,one of them showed α waves enhancing,the other showed θ waves increasing obviously.Conclusion:(1) The degree of abnormal EEG changes in hyperacute time of acute cerebral infarction might have instructive meaning in selecting thrombolysis treatment.(2)Hyperacute thrombolysis in the process of EEG monitoring can be used as predicting index of current disease development of acute cerebral infarction.