动态脑电图在昏迷病人预后评估中的意义-临床医学专业论文.docxVIP

动态脑电图在昏迷病人预后评估中的意义 摘要 【目的】 比较昏迷病人、正常人的动态脑电图( AEEG )、脑电地形图（BEAM） 变化特点以及其对昏迷病人预后评估中的诊断意义。 【方法】对105例昏迷患者（昏迷组）分别行GLASSGOW评分及AEEG分级，并 与90例正常人（正常组）行波谱分析检查并进行比较分析。 【结果】 1、 脑电图分级为I级：GCS为12.43±1.56,II级时GCS为10.90±2.16,III级时GCS 为8.70±3.80, IV级时GCS为6.89±2.47；V级时GCS为3.75±0.96; 脑电图异常 分级与GCS评分负相关（r=0.584，p0.001）， 2、动态脑电图对昏迷患者预后的评估在敏感性(86.4%)、特异性（74.7%）和对 预后评估的准确性（79.0%）方面均比GCS评分敏感性(70.0%)、特异性（73.9%） 和对预后评估的准确性（70.5%）评分高。 3、 昏迷组与对照组各主频分布比较见：对照组各脑区主频均数在9Hz以上，大 部分受试者为α波频段，而昏迷组主频均数都在8Hz以下，两组比较，各脑区 主频差异均有显著性意义 【结论】动态脑电图检测对植物状态和残疾生存患者预后的评估有确切肯定的价 值。 【关键词】昏迷 动态脑电图 glasgow评分 频谱分析 预后 Prognostic value of dynamic electroneurophysiology in comatose patients Abstract [Objective] To compare the characteristics and diagnostic value of electroencephalogram (EEG) ， brain electrical activity mapping （ BEAM ）、 in comatose patient and normal control and evaluate the prognostic value of dynamic EEG in comatose patients. [Method] EEG , Glasgow and spectrum analysis of comatose patients (n=105) and normal control (n=90) were taken，compared, and analyzed. [Results] 1、The grade of dynamic electroencephalogram was negatively related to the Glasgow score(r= -0.584,p0.001).When the dynamic electroencephalogram was grade I,the Glasgow score was 12.43 ± 1.56,when the dynamic electroencephalogram was grade II ,the Glasgow score was 10.90±2.16,when the dynamic electroencephalogram was grade III,the Glasgow score was 8.70± 3.80,when the dynamic electroencephalogram was grade IV,the Glasgow score was 6.89±2.47,and when the dynamic electroencephalogram was grade V,the Glasgow score 3.75±0.96. 2、The sensibility rate,specificity rate,and accuracy rate of dynamic electroencephalogram in prognosis prediction Were 87.5%,76.9%,and 80.9% respectively,all higher than those of Glasgow score.The error rate of dynamic electroencephalogram in prognosis prediction was 19.0%,and that of Glasgow score was 29.0%. 3、The EEG electric power of the comatose patients was significantly lower than that of nor