脑电图动态检测对急性缺血性脑卒中临床应用研究

Study on the clinical application of electroencephalogram(EEG) ambulatory monitoring in acute cerebral ischemia

目的 :探讨脑电图 (EEG)动态检测在急性缺血性脑卒中的临床应用价值。方法 :采用SW—JH2 0 0 0AR智能化脑电监护仪 ,对 5 0例脑梗死患者治疗前后EEG进行动态检测。结果 :观察组EEG基本节律异常 98% ,病例慢波优势 76 %。早期EEG异常较CT敏感 (P <0 0 1) ,其异常程度与病变部位、病灶大小及病情轻重相关 ;其中 8例超早期 (<6h)尿激酶静脉溶栓病例 ,随肌力迅速改善异常EEG明显改善。结论 :(1)脑电图对急性脑缺血敏感 ,脑电图病理波的出现及改变程度有助于对该病的早期诊断、治疗及预后判断 ;(2 )发病超早期 (<6h)EEG异常程度对早期选择溶栓治疗有指导意义 。

Objective:To explore the clinical valuable significance of EEG ambulatory monitoring in acute ischemia stroke.Methods:EEG monitoring of pre-and post-treatment were done in 50 patients with cerebral infarction by SW-JH 2000AR intelligentized electroencephalogical monitor instrument.Results:49 patients showed abnormal EEG basic rhythm and 38 patients had predominant slow waves on the diseased hemisphere.Early EEG abnormality was more sensitive than CT(P<0 01).The degree of abnormal EEG change was correlated to location,size and severity of the tesions.Myodynamia of 8 patients who were introvenously injected urokinase(UK) in hyperacute time(<6hours) recovered remarkly with improvement of EEG changes.Conclusions:①EEG changes are highly sensitive to acute cerebral ischemia.Appearance and the alterative degree of pathological EEG waves might be helpful for early diagnosis,treatment and prognosis of cerebral infarction.②The degree of abnormal EEG changes in hyperacute time of acute cerebral ischemia might have instructive meaning in selecting thrombolysis treatment.The synchronous EEG monitoring can be used as predicting index for early disease development and prognosis of acute cerebral infarction.