体感诱发电位对轻型颅脑损伤患者的评估

The Evaluation of Somatosensory Evoked Potentials for Patients with Mild Traumatic Brain Injury

目的探讨体感诱发电位 (SEP)对轻型颅脑损伤患者功能及预后的评估价值。方法对 32例轻型颅脑损伤患者 (疾病组 )康复治疗前及治疗 2周后行 SEP检测及 ADL评定。 3个月后进行随访 ,并行脑外伤后综合征的临床测试 ,复查 SEP,比较 SEP与 CT检查结果 ,对照分析 SEP对脑功能损伤的评估、与 ADL 及预后的关系。结果 1疾病组治疗前 SEP异常率为 4 6 .9% ,CT异常率 34.4 % ,SEP高于 CT异常率。SEP异常主要表现为 :N2 0 潜伏期及N1 3- N2 0 峰间潜伏期的延长。 2与正常组比较 ,疾病组 SEP的 N2 0 潜伏期及 N1 3- N2 0 峰间潜伏期明显延长 (P <0 .0 5 ) ,治疗后有改善 ,但仍高于正常组。 3治疗前 SEP异常患者的 ADL评分明显低于 SEP正常的患者 (P <0 .0 5 )。 4 3个月后随访发现首检 SEP异常的脑外伤后综合征高于 SEP正常的患者 (P<0 .0 5 )。结论在轻型颅脑损伤的评估中 ,SEP检查较 CT扫描更灵敏。 SEP可反映轻型颅脑损伤患者脑功能障碍的程度 ,并可为预后判断提供依据。

Objective\ To study the value of somatosensory evoked potentials (SEP) in evaluating the cerebral function and judging the prognosis of the patients with mild traumatic brain injury. Methods\ 32 cases of mild traumatic brain injury were examined by SEP and assessed with Barthel for activities daily living (ADL) before comprehensive rehabilitation treatment and 2 weeks later. Three months later the patients were followed up, SEP re examined and post concussing syndrome assessed. The results between SEP and CT were compared. The relationship between SEP and degree of brain damage and ADL and prognosis was analyzed. Results (1) The abnormal rate of SEP was 46 9 % in the patients with mild traumatic brain injury before treatment, higher than that of CT (34 4 %). The main abnormities of SEP included the delay of latent period in N 20 and N 13 -N 20 ;(2) Compared with the control group, the latent period of N 13 -N 20 was markedly delayed ( P <0 05). The latent period was improved after treatment, but it was still longer than normal;(3) Before rehabilitation treatment, the grade of ADL of the patients with abnormal SEP result was lower distinctly than that of the patients with normal SEP result ( P< 0 05); (4) The rate of post concussion syndrome in patients with abnormal SEP was higher than that with normal SEP examination (P <0 05). Conclusion In evaluation of mild traumatic brain injury, SEP was more sensitive than CT. SEP could reflect the degree of brain damage and provide evidence for prognosis.