重症脑血管病患者持续脑电监测及预后分析
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摘要
目的探讨重症脑血管病患者脑电图变化,并分析其预后。方法选取本院收治的60例重症脑血管病、且均行连续脑电图检测(continuous electroencephalogram monitoring,CEEG)的患者,分析CEEG分级与预后的关系。结果本组60例患者中19例CEEG表现为弥散性慢活动,3例死亡;4例表现为间歇性δ节律,无1例死亡;12例癫痫样活动,3例死亡;4例三相波,2例死亡;5例单节律活动,均死亡;9例低波幅活动,均死亡;6例局灶性异常,无1例死亡;1例爆发-抑制性类型,死亡。CEEG中Ⅰ~Ⅱ级存活率为92.31%(12/13)、Ⅲ级为60.71%(17/28)、Ⅳ~Ⅴ级为31.58%(6/19),差异有统计学意义(P<0.05)。Spearman等级相关性分析结果显示,CEEG分级与预后呈正相关(r2=0.76,P<0.05)。结论 CEEG可作为判断重症脑血管病患者预后的重要方式。
Objective To investigate the EEG changes in patients with severe cerebrovascular disease and the prognosis. Methods Sixty cases of patients with severe cerebrovascular disease were selected as the research objects. All of them underwent continous electroencephalogram(CEEG) detection. The relationship between CEEG grading and prognosis was analyzed. Results Of the 60 patients, 19 showed diffuse slow activity and 3 died. Four cases showed intermittent roup, without death. Twelve showed epileptiform activity and 3 died. Four showed three-phase wave and 2 died. Five cases of single-rhythm activity all died. Nine cases with low volatility activity all died. There were 6 cases of focal abnormalities, without death and 1 case of outbreak-suppression type, died. The survival rate of CEEG gradeⅤ~Ⅴ was 92.31%(12/13), of grade Ⅴ was 60.71%(17/28) and of grade Ⅴ~Ⅴ was 31.58%(6/19), the difference was statistically significant(P<0.05). Spearman rank correlation analysis showed EEG grading and prognosis were positively correlated(r = 0.76,P<0.05). Conclusion CEEG can be taken as an important way of evaluating the prognosis of patients with severe cerebrovascular disease.
Objective To investigate the EEG changes in patients with severe cerebrovascular disease and the prognosis. Methods Sixty cases of patients with severe cerebrovascular disease were selected as the research objects. All of them underwent continous electroencephalogram(CEEG) detection. The relationship between CEEG grading and prognosis was analyzed. Results Of the 60 patients, 19 showed diffuse slow activity and 3 died. Four cases showed intermittent roup, without death. Twelve showed epileptiform activity and 3 died. Four showed three-phase wave and 2 died. Five cases of single-rhythm activity all died. Nine cases with low volatility activity all died. There were 6 cases of focal abnormalities, without death and 1 case of outbreak-suppression type, died. The survival rate of CEEG gradeⅤ~Ⅴ was 92.31%(12/13), of grade Ⅴ was 60.71%(17/28) and of grade Ⅴ~Ⅴ was 31.58%(6/19), the difference was statistically significant(P<0.05). Spearman rank correlation analysis showed EEG grading and prognosis were positively correlated(r = 0.76,P<0.05). Conclusion CEEG can be taken as an important way of evaluating the prognosis of patients with severe cerebrovascular disease.
引文
[1]郑莉,李德强,董文辉,等.27例重症脑血管病患者的救治体会[J].脑与神经疾病杂志,2013,21:334-338.
[2]中华神经科学会中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29:379-380.
[3]Synek VM.Prognostically important EEG coma patterns in diffuseanoxic and traumatic encephalopathies in adults[J].J Clin Neuro-physiol,1988,5:161-174.
[4]王维治,罗组明.神经病学[M].4版.北京:人民卫生出版社,2002:149-151.
[5]马国胜,彭彩丽,张东,等.急性重症脑血管病死亡风险的多因素分析及预测[J].中华老年心脑血管病杂志,2013,5:540-541.
[6]佟书琴,吴立文.6例蛛网膜下腔出血伴痫样发作的脑电图分析[J].北京医学,2013,35:98.
[7]叶斌,王菲,苗青,等.动态脑电监测对急危重症脑血管病的预后评估[J].解剖与临床,2011,16:302-304.
[8]赵亮,高燕军,杨利军,等.长程脑电图对重症脑血管病患者脑功能及预后的评价[J].河北医科大学学报,2013,34:1454-1457.
[9]吕晓民,吕晓萍,吕洋,等.脑电图检查对老年脑血管病重症患者的诊断价值[J].中国老年学,2011,31:1474.
[10]杨亚川,但炜,孙晓川.脑电图在重症脑损伤后脑功能评价的研究进展[J].临床神经外科杂志,2015,12:147-149.
[11]吴琴,牛小媛.120例重症脑血管病患者脑电图分级比较[J].中西医结合心脑血管病杂志,2010,8:816-818.
[12]王珺,范玮,李尔珍,等.脑电图监测对儿童病毒性脑炎急性期病情及预后的评估意义[J].北京医学,2014,36:440-443.
[2]中华神经科学会中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29:379-380.
[3]Synek VM.Prognostically important EEG coma patterns in diffuseanoxic and traumatic encephalopathies in adults[J].J Clin Neuro-physiol,1988,5:161-174.
[4]王维治,罗组明.神经病学[M].4版.北京:人民卫生出版社,2002:149-151.
[5]马国胜,彭彩丽,张东,等.急性重症脑血管病死亡风险的多因素分析及预测[J].中华老年心脑血管病杂志,2013,5:540-541.
[6]佟书琴,吴立文.6例蛛网膜下腔出血伴痫样发作的脑电图分析[J].北京医学,2013,35:98.
[7]叶斌,王菲,苗青,等.动态脑电监测对急危重症脑血管病的预后评估[J].解剖与临床,2011,16:302-304.
[8]赵亮,高燕军,杨利军,等.长程脑电图对重症脑血管病患者脑功能及预后的评价[J].河北医科大学学报,2013,34:1454-1457.
[9]吕晓民,吕晓萍,吕洋,等.脑电图检查对老年脑血管病重症患者的诊断价值[J].中国老年学,2011,31:1474.
[10]杨亚川,但炜,孙晓川.脑电图在重症脑损伤后脑功能评价的研究进展[J].临床神经外科杂志,2015,12:147-149.
[11]吴琴,牛小媛.120例重症脑血管病患者脑电图分级比较[J].中西医结合心脑血管病杂志,2010,8:816-818.
[12]王珺,范玮,李尔珍,等.脑电图监测对儿童病毒性脑炎急性期病情及预后的评估意义[J].北京医学,2014,36:440-443.