振幅整合脑电图对ICU中枢功能障碍患者脑功能评价及生存预后评估的研究

Evaluation of brain function and survival prognosis with aEEG in ICU patients with central nervous dysfunction

目的:探讨振幅整合脑电图(aEEG)在ICU中枢功能障碍患者预后评估中的价值。方法:选择60例在我院ICU接受治疗的中枢功能障碍患者进行aEEG监测,包括行格拉斯哥昏迷量表评分(GCS)和aEEG监测,确定aEEG、GCS评分,并使用Kaplan-meier生存曲线图以及生存预后的单因素与多因素分析方法分析各因素与预后之间的关系。结果:1通过生存预后的单因素与多因素分析显示年龄、性别、有无癫痫发作、有无自主呼吸及有无高热与预后无明显相关性,而aEEG、GCS评分与预后有明显相关性(P<0.05);2对患者进行生存预后分析,结果显示在第24小时、72小时以及1周3个时间节点,使用aEEG评分来评估患者的生存预后要比使用GCS评分方法来评估更好(aEEG<4分及GCS<8分)(P<0.01)。结论:aEEG评分预测患者的生存预后明显好于GCS评分(aEEG<4分及GCS<8分),可以根据aEEG评分对ICU中枢功能障碍患者的神经功能恢复以及生存预后进行预测。

Objective：To explore the role of ambulatory EEG（AEEG） monitoring in ICU patients with dys- function of central nervous system and to evaluate the value of prognosis. Method..aEEG monitoring was performed in 60 patients with central dysfunction treated by ICU in our hospital： including the Glasgow Coma Scale （GCS） and aEEG monitoring,then,the relationship between various factors and prognosis was analyzed by univariate and multivariate analysis using Kaplan-meier survival curve and survival prognosis. Result： ① Univariate and multivari- ate analysis showed that age, sex, seizure, spontaneous breathing and fever were not associated with prognosis, while aEEG,GCS had significant correlation with the prognosis （P〈0.05）,and showed a linear correlation. ②For the survival analysis of patients, the results showed that at 24 hours. 72 hours and the seventh days, the aEEG score was used to assess the survival of patients with a better outcome than the GCS score （aEEG〈4 score and GCS〈8 score）（P〈0. 01）. Conclusion：The survival rate of patients with aEEG score was significantly better than that of GCS score （aEEG〈4 score and GCS〈8 score）, According to aEEG score,neurological function recovery and survival prognosis of patients with ICU central dysfunction were predicted.