两种体感诱发电位分级标准对重症脑功能损伤预后预测的比较

Prediction comparison of prognosis in severe cerebral dysfunction by somatosensory evoked potential according to two grading standards

目的运用体感诱发电位(SEP)早期预测重症脑功能损伤预后。方法通过对66例累及大脑半球病变的急性脑血管病患者动态监测(SEP)和格拉斯哥评分(GCS)变化,依据两种分级标准(Judson标准、Zentner标准)进行SEP分级比较。结果按照两种标准分级的SEP变化均与预后有相关性(P<0.01),SEP级别越高,预后越差。经Logistic回归分析,Judson标准的死亡预测准确率及生存和死亡综合预测的准确率均高于Zentner标准和GCS。结论动态监测Judson标准的SEP级别变化能较好地反映脑功能损伤的变化过程,早期预测预后准确率较高。

Objective The aim of this study was to predicate the prognosis of severe cerebral dysfunction early by somatosensory evoked potential （ SEP ） .Methods All the 66 patients who suffered from acute cerebral vascular disease （ CVD ） in the hemisphere were recorded SEP dynamically , and SEP grades according to two different SEP grading standards （ Judson and Zentner ） were compared .Results Two different SEP grading standards showed much closer correlation with outcome （ P〈0.01）：the higher the SEP grade was , the poorer the outcome was . Logistic regression showed that the Judson standard was better for prognostic accuracy of death and of both survival and death.Conclusion The dynamical SEP grading standard of Judson demonstrates the change of cerebral dysfunction much better and is a reliable and early predictor of the outcome in severe cerebral dysfunction .