脑干听觉诱发电位在颅脑损伤诊治中的应用

Application of brainstem auditory evoked potential to diagnosis and treatment of acute craniocerebral trauma

目的探讨脑干听觉诱发电位在颅脑损伤诊治及预后随访中的应用效果。方法2014年7月至2015年12月收治颅脑损伤96例，按入院时GCS评分分成观察A组（GCS评分9—15分）与观察B组（GCS评分3-8分），各48例；另选取健康受试者48例作为对照；均接受床旁脑干听觉诱发电位检查。随访6个月，根据GOS评分分为良好组（GOS评分4～5分）和不良组（GOS评分1-3分），各48例。以健康受试者脑干听觉诱发电位作为参考值，将颅脑损伤脑干听觉诱发电位改变分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级。结果观察A组脑干听觉诱发电位改变分级明显优于观察B组（P〈0．05）。良好组脑干听觉诱发电位改变分级明显优于不良组（P〈0．05）。良好组脑干听觉诱发电位好转36例，恶化18例；不良组好转15例，恶化33例。良好组好转率（75．00％）明显高于不良组（31．25％；P〈0．05）。结论脑干听觉诱发电位在颅脑损伤诊治及预后评估中具有重要意义。

Objective To study the values of brainstem auditory evoked potential （BAEP） to diagnosis and treatment of acute craniocerebral trauma. Methods Ninety-six patients with acute craniocerebral trauma treated in our hospital from July, 2014 to December, 2015 were divided into observation group A （GCS scores, 9-15 points） and observation group B （GCS scores, 3-8 points） of 48 patients each according to GCS score. And 48 healthy subjects served as the control group. All the patients received BAEP examination beside the bed. All the patients were followed up for 6 months and their prognoses were assessed by GOS score. Results The rates of BAEP changing degrees Ⅰ and Ⅱ were significantly higher in observation group A and good prognosis （GOS score, 4-5 points） group than those respectively in the observation group B and poor prognosis （GOS score, 1-3 points） group （P〈0.05）. The rates of BAEP changing degrees Ⅲ and Ⅳ were significantly lower in the observation group A and good prognosis group than those in the observation group B and poor prognosis group （P〈0.05）. The rate of good BAEP （75.00%, 36/48） was significantly higher in the good prognosis group than that （31.25%%, 15/48） in the poor prognosis group 6 months after the discharge from the hospital （P〈0.05）. Conclusion BAEP is of high importance to the diagnosis, treatment and prognostic assessment of patients with acute craniocerebral trauma.