闭合性颅脑外伤患者病程与P_(300)之间关系的研究

Study on the relationship between the course of disease and P_( 300) in patients with closed craniocerebral trauma

目的 研究闭合性颅脑外伤患者病程与 P30 0 之间的关系 ,并探讨此类患者作 P30 0 测定的最佳时间。方法 应用 Medicid- 0 3E脑诱发电位仪测定 5 18例闭合性颅脑外伤患者的视觉 (图像 )刺激诱发的 P30 0 波之潜伏期和波幅。对其中异常的 385例与 2 14例正常对照组作比较 ,并比较不同伤情、伤后不同时间患者的P30 0 波。结果 病人组 P30 0 波潜伏期较正常对照组明显延长 (P<0 .0 0 1) ,波幅亦明显降低 (P<0 .0 1) ,其 P30 0 改变在伤后 2 5～ 48小时内明显 ,尤以伤后有昏迷者更为突出。随着时间的延长 ,P30 0 波异常程度有所改善。结论 P30 0 波的变化可作为判断闭合性颅脑外伤患者脑认知功能变化的一项客观指标 ,其中伤后 2 5～ 48小时内测定具有更高的价值 ,根据 P30 0 波的变化能判断患者的伤情和预后。

Objective To study the relationship between the course of disease and P 300 in patients with closed craniocerebral trauma, and investigate the optimum time for P 300 assay.Methods With medicid 03E brain evoked potential instrument, the latency and the amplitude of P 300 evoked by visual (image) stimulation were recorded in 518 patients with closed craniocerebral trauma, in which 385 abnormal cases were compared with 214 normal subjects,as compared with the P 300 during different condition of injury and different time after injury.Results P 300 latency in patient group was significantly prolonged as compared with the control group ( P <0.001),the amplitude was significantly decreased ( P <0.01),the change of P 300 was significant from 25 h to 48 h after injury, especially in patients with coma. With the prolonging of time, the abnormal level of P 300 was improved. Conclusion The change of P 300 might be taken as an objective index of judging the changes of the brain cognitive function in patients with closed craniocerebral trauma,among which from 25 h to 48 h after injury had higher value. The change of P 300 was useful and helpful for judging the patients’ condition and prognosis.