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目的 :探讨脑干反射 (BSR)和脑干听觉诱发电位 (BAEP)在观察脑干损伤病人的病情变化、判断预后方面的价值。方法 :对 70例脑干损伤病人同时进行BSR、BAEP监测。分析BSR、BAEP与格拉斯哥昏迷计分 (GCS)、格拉斯哥预后分级 (GOS)之间的关系以及 2 5例临终状态时BSR、BAEP情况 ,同时研究早期脑疝病人的BAEP变化。结果 :BSR、BAEP与病人的GCS、GOS密切相关 ,BSR平面越低 ,病情越重 ,预后越差 ;BAEP异常程度与病情轻重基本一致 ,双侧或一侧Ⅰ、Ⅲ、Ⅴ波平坦 ,提示预后不佳。脑死亡者绝大多数BSR属Ⅵ平面 ,BAEP双侧各波呈电平坦。脑疝早期BAEP主要表现为一侧波Ⅴ消失或波Ⅰ～Ⅴ、Ⅲ～Ⅴ峰间潜时 (IPL)延长。结论 :BSR、BAEP可用来观察病情、判断预后 ,可作为脑死亡的诊断标准之一 ,BAEP有助于早期发现脑疝 ,指导治疗
Objective: To investigate the value of predicting the prognosis of brainstem reflex (BSR) and brainstem auditory evoked potentials (BAEP) in observing the changes of patients with brain stem injury. Methods: 70 cases of brainstem injury patients at the same time BSR, BAEP monitoring. The relationship between BSR, BAEP and Glasgow Coma Scale (GCS) and Glasgow Grading Scale (GOS) was analyzed. The BSR and BAEP in 25 cases of terminal state were also analyzed. The BAEP changes in patients with early cerebral hernia were also studied. Results: The BSR and BAEP were closely related to the GCS and GOS of the patients. The lower the BSR and the worse the prognosis, the more abnormal the BAEP and the less severe the disease, the more flat the Ⅰ, Ⅲ and Ⅴ waves on both sides or one side Poor prognosis. Most brain dead BSR is VI plane, BAEP bilateral wave was flat. Early BAEP of cerebral hernia mainly showed disappearance of wave Ⅴ on one side or prolongation of latency (IPL) between Ⅴ and Ⅲ ~ Ⅴ of waves. Conclusion: BSR and BAEP can be used to observe the disease and prognosis, which can be used as one of the diagnostic criteria of brain death. BAEP can help to find out the early hernia and guide the treatment