动态脑电图联合儿童改良GCS对儿童重症监护病房非创伤性意识障碍患儿不良结局的预测效果

Predictive Effect of Dynamic Electroencephalogram Combined with Pediatric Modified GCS on Adverse Outcomes in Children with Non-traumatic Consciousness Disorders in Pediatric Intensive Care Units

目的:探讨动态脑电图(EEG)联合儿童改良格拉斯哥昏迷评分(GCS)对儿童重症监护病房(PICU)非创伤性意识障碍(NCA)患儿不良结局的预测效果。方法:选取2021年6月—2022年12月于广西医科大学第一附属医院PICU进行治疗的NCA患儿69例作为研究对象。所有患儿接受动态EEG监测、儿童改良GCS评估并预测治疗结局,随访1年,比较动态EEG、儿童改良GCS单独及二者联合预测患儿不良结局的效果。结果:1年后,69例患儿中预后不良37例,占比53.62%,预后良好32例,占比46.38%。联合检测准确度高于儿童改良GCS,特异度、阳性预测值高于动态EEG与儿童改良GCS,动态EEG灵敏度、特异度高于儿童改良GCS,差异有统计学意义(P<0.05);三组阴性预测值比较,差异无统计学意义(P>0.05)。结论:动态EEG联合儿童改良GCS对PICU中NCA患儿预后预测价值较高。

Objective:To investigate the predictive effect of dynamic electroencephalogram(EEG)combined with pediatric modified Glasgow coma score(GCS)on the adverse outcome of children with non-traumatic consciousness disorder(NCA)in pediatric intensive care unit(PICU).Methods:Sixty-nine children with NCA who were treated in the PICU of the First Affiliated Hospital of Guangxi Medical University from June 2021 to December 2022 were selected as the study subjects.All children received dynamic EEG monitoring,pediatric modified GCS assessment and prediction of treatment outcome,and were followed up for one year to compare the effects of dynamic EEG,pediatric modified GCS alone and the combination of the two in predicting adverse outcomes in children.Results:After one year,among sixty-nine children,thirty-seven cases(53.62%)had a poor prognosis,and thirty-two cases(46.38%)had a good prognosis;the accuracy of the combined test was higher than that of the pediatric modified GCS,and the specificity and positive predictive value were higher than that of the dynamic EEG and pediatric modified GCS,and the dynamic EEG sensitivity and specificity were higher than that of the pediatric modified GCS,and the difference was statistically significant(P<0.05);comparison of negative predictive values among the three groups,the difference was not statistically significant(P>0.05).Conclusion:Dynamic EEG combined with pediatric modified GCS has high prognostic predictive value for children with NCA in PICU.