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目的探讨动态脑电图(AEEG)、脑干听觉诱发电位(BAEP)和体感诱发电位(SEP)监测在昏迷预后评估中的应用。方法对60例昏迷患者进行AEEG、BAEP和SEP监测,AEEG按照Young的分级方法分为5级,参照杨柏捷的分级方法将BAEP分为3级,参照Cant的分级方法将SEP分为3级,并与患者3个月后的预后相比较。结果 AEEGⅠ级BAEPⅠ级SEPⅠ级患者14例,10例清醒,2例植物生存状态,2例(14.3%)死亡;AEEGⅡ级BAEPⅡ级SEPⅡ级患者15例,5例清醒,4例植物生存状态,6例(40.0%)死亡;AEEGⅢ级BAEPⅡ级SEPⅡ级患者13例,3例清醒,3例植物生存状态,7例(53.8%)死亡;AEEGⅣ～Ⅴ级BAEPⅢ级SEPⅢ级患者18例,0例清醒,1例植物生存状态,17例(94.4%)死亡。结论 AEEG、BAEP和SEP分级的高低与昏迷患者的临床预后关系密切,随着电生理级别的升高,患者病死率递升(P<0.05)。AEEG、BAEP和SEP监测在昏迷的预后评估中具有重要作用。
Objective To investigate the application of dynamic electroencephalogram (AEEG), brainstem auditory evoked potential (BAEP) and somatosensory evoked potential (SEP) in the assessment of coma prognosis. Methods Sixty coma patients were monitored by AEEG, BAEP and SEP. The AEEG was divided into five grades according to Young’s classification method. The BAEP was divided into three grades according to the Yang Bujie’s classification method. According to Cant’s classification method, SEP was divided into three grades Compared with the patient’s prognosis after 3 months. Results There were 14 patients with AEEG grade Ⅰ BAEP Ⅰ SEPⅠ, 10 patients were awake, 2 patients were alive and 2 patients died (14.3%). Fifteen patients with AEEG Ⅱ grade BAEP Ⅱ SEP Ⅱ, 5 patients were awake, 4 patients were alive, 6 (40.0%) died; 13 patients with AEEG Ⅲ grade BAEP Ⅱ SEP Ⅱ level, 3 patients were awake, 3 patients were in vegetative state and 7 patients (53.8%) died; 18 patients with AEEP Ⅳ ~ Ⅴ BAEPⅢ level SEP Ⅲ, , 1 case of vegetative state, 17 cases (94.4%) died. Conclusions The levels of AEEG, BAEP and SEP are closely related to the clinical prognosis of patients with coma. As the electrophysiological level increases, the patients’ mortality rate increases (P <0.05). The monitoring of AEEG, BAEP and SEP plays an important role in the evaluation of the prognosis of coma.