昏迷患者脑电图分级与振幅整合脑电图的比较性分析

Comparative analysis of electroencephalography(EEG)grading and amplitude-integrated EEG in coma patients

目的:分析比较脑电图(EEG)Young分级和振幅整合脑电图(aEEG)在昏迷患者预后判断中的应用。方法:选取2020年1月—2022年8月中日友好医院收治的70例昏迷患者作为研究对象,采用EEG分级和aEEG 2种方法对患者预后进行预判,并与实际临床预后进行比较。结果:70例昏迷患者EEG Young分级与aEEG对预后的判断与临床预后的Kappa值分别0.572和0.561(P<0.05),二者间的一致性检验Kappa值为0.854(P<0.05)。EEG与aEEG预判预后的敏感性分别为82.22%、75.56%,特异性分别为76.00%、84.00%,阳性预测值分别为86.05%、89.47%,阴性预测值分别为70.37%、65.63%,两者间差异均有统计学意义(均P<0.05)。对于伴癫痫波形的分析aEEG需结合EEG分析鉴别。结论:EEG和aEEG对昏迷患者的预后判断均有一定价值,二者的一致性较强,表明aEEG这一新的脑电监护技术可以应用于昏迷患者预后的判断。EEG的敏感性、阴性预测值高于aEEG,aEEG的特异性、阳性预测值高于EEG;两者联合分析值得临床推广应用。

Objective:To analyze the application of electroencephalography(EEG)Young grades and amplitudeintegrated electroencephalography(aEEG)in the prognostic evaluation of coma patients.Methods:From January2020 to August 2022,70 coma patients admitted to our hospital were selected as the subjects of study.The prognosis of the patients was evaluated by aEEG monitoring,EEG Young grades,and the value of prognostic judgment was analyzed.Results:In the 70 patients with coma,the Kappa values of EEG Young grades and aEEG for prognostic evaluation and follow-up were 0.572,and 0.561 respectively(P<0.05).The Kappa value of consistency test between them was 0.854(P<0.05).The sensitivity of EEG and aEEG were 82.22% and75.56%,the specificity were 76.00% and 84.00%,the positive predictive values were 86.05% and 89.47%,the negative predictive values were 70.37% and 65.63%(all P<0.05).For the analysis of epileptic waveform,aEEG should be identified with EEG analysis.Conclusion:EEG and aEEG both have certain values in the prognosis judgment of coma patients.As to aEEG,a new EEG monitoring technique,it can be used to determine the prognosis of coma patients.The sensitivity and accuracy rate of EEG are higher than those of aEEG.The specificity,positive predictive value,negative predictive value,and inaccuracy rate of aEEG are higher than those of EEG.The combination of the two is worthy of clinical application.