头皮脑电图对动脉瘤性蛛网膜下腔出血继发脑血管痉挛的预测价值

Predictive value of EEG for secondary cerebral vasospasm after aneurysmal subarachnoid hemorrhage

目的:探究动脉瘤性蛛网膜下腔出血头皮脑电图(EEG)的特点,比较EEG不同波型与aSAH继发脑血管痉挛的关系,探讨头皮脑电图波型对aSAH后脑血管痉挛发生的预测价值。方法:前瞻性分析我院2017年12月—2018年12月48例aSAH患者脑电图资料。按照有无脑血管痉挛发生分为发生组(分早期组和晚期组)与非发生组。头皮脑电图波形分为:Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型及Ⅴ型,比较各组波形特征。结果:①48例aSAH患者中有14例发生脑血管痉挛,其发生率为29.2%,早期痉挛4例(8.3%),晚期痉挛10例(20.8%)。②发生组中脑电图类型以Ⅱ、Ⅲ型为主(85.7%),非发生组以Ⅰ、Ⅱ、Ⅲ型为主(88.2%);发生组中Ⅱ型和Ⅲ型的比例(85.7%)显著高于非发生组(64.7%)(P<0.05)。③早期痉挛组与晚期痉挛组脑电图类型构成比差异显著(P<0.05),早期痉挛组以Ⅱ型最多(75.0%),晚期痉挛组以Ⅲ型最多(60.0%)。结论:头皮脑电图对a S A H继发脑血管痉挛有一定的预测价值,Ⅱ和Ⅲ型为a S A H继发脑血管痉挛的高危波型。

Objective To analyze the characteristics of EEG in the patients of aSAH,compare the relationship of different brain wave patterns with secondary cerebral vasospasm after aSAH,and assess the predictive value of EEG patterns for vasospasm.Methods A prospective study was performed on the EEG data of 48 aSAH patients.According to the occurrence of cerebral vasospasm,the patients were divided into occurrence group(early group and late group)and non-occurrence group.The EEG patterns were divided into typeⅠ,Ⅱ,Ⅲ,ⅣandⅤ,and comparison of waveform characteristics in different groups.Results①In the 48 aSAH patients,there were 14 patients with vasospasm,with an incidence rate of 29.2%,including 4 cases(8.3%)of early vasospasm and 10 cases of advanced vasospasm(20.8%).②The type of EEG in the occurrence group was mainly type Ⅱ,Ⅲ(85.7%),and that in the non-occurrence group was mainly type Ⅰ,Ⅱ,Ⅲ(88.2%),and the proportion of type Ⅱ and Ⅲ in the occurrence group(85.7%)was significantly higher than that in the non-occurrence group(64.7%)(P<0.05).③There were significant differences in the EEG patterns between the early and late vasospasm groups(P<0.05).Type Ⅱ was the most frequent type in the early group(75.0%),and type Ⅲ was in the late group(60.0%).Conclusion EEG has a predictive value for secondary vasospasm after aSAH.Types Ⅱ and Ⅲ are high-risk wave types for secondary vasospasm.