恢复期脑干听觉诱发电位对儿童严重意识障碍预后的预测价值研究

Study on the predictive value of brainstem auditory evoked potential in convalescence for the prognosis of children with severe disorders of consciousness

目的探讨恢复期脑干听觉诱发电位(BAEP)对各种获得性脑损伤(创伤、感染、缺氧等)所致的儿童严重意识障碍(DOC)预后的预测价值。方法对2013年7月至2021年12月在该院首次接受康复治疗并完成BAEP检查的228例DOC患儿的预后进行回顾性研究。结果缺氧缺血性脑损伤组患儿BAEP的Ⅴ波均保留;在创伤性脑损伤、颅内感染、其他病因组中,双侧V波存在的患儿病程3个月时的意识恢复率和1年时的功能结局良好率并未高于单/双侧V波缺失患儿,差异均无统计学意义(P>0.05);多因素logistic回归分析显示,V波存在与否对病程1年时功能结局的影响差异无统计学意义(OR=0.916,95%CI 0.542~1.549,P>0.05)。结论恢复期BAEP并未显示对各种获得性病因所致的DOC患儿近期(病程3个月)及远期(病程1年)预后预测的价值。

Objective To explore the predictive value of brainstem auditory evoked potential(BAEP)in convalescence for theprognosis of children with severe disorders of consciousness(DOC)caused by various acquired brain injuries(trauma,infection,hypoxia,etc.).Methods From July 2013 to December 2021,the prognosis of 228 children with DOC who received rehabilitation treatment for the first time and completed BAEP examination in this hospital was retrospectively studied.Results The wave V of BAEP in children with hypoxic-ischemic brain injury group were all preserved.In the traumatic brain injury,intracranial infection and other etiological groups,the recovery rate of consciousness at three months and the good rate of functional outcome at one year in children with bilateral V wave were not higher than those with unilateral/bilateral V wave loss,and the differences were not statistically significant(P>0.05).Multivariate logistic regression analysis showed that the presence or absence of V wave had no statistical significance on the functional outcome at one year(OR=0.916,95%CI 0.542-1.549,P>0.05).Conclusion BAEP in convalescence does not show its value in predicting the short-term(3-month course)and long-term(1-year course)prognosis of DOC children caused by various acquired causes.