连续脑电图监测对重症脑出血脑功能损伤的评价

    Role of continuous electroencephalography monitoring in assessing patients with critical cerebral hemorrhage

    • 摘要: 目的:探讨连续脑电图(CEEG)监测对重症脑出血患者脑功能损伤评价和预后判断的应用价值。方法:对格拉斯哥昏迷评分≤ 8分的急性重症脑出血患者30例进行床边中央神经监护系统记录CEEG,按Young分级标准分级判断,随访患者2个月的预后,将CEEG分级与预后进行相关分析。结果:30例重症脑出血患者的CEEG全部异常,发生癫痫样活动者4例,其中非痉挛性癫痫发生率为10%,痉挛性癫痫的发生率为3.3%。CEEGⅠ~Ⅱ级者预后不良率为11.8%,CEEGⅢ~Ⅵ级预后不良率达53.8%,差异有统计学意义(P=0.019)。结论:CEEG和分级结果与预后显著相关,可以准确、客观地评价和预测神经科重症脑出血患者脑功能损伤的预后。

       

      Abstract: Objective: To evaluate continuous electroencephalography (CEEG) monitoring in assessing and predicting the prognosis of patients with critical cerebral hemorrhage.Methods: CEEG's classification was dynamically recorded at the bedside of 30 cases of critical cerebral hemorrhage with Glasgow coma scale ≤ 8.The outcome was evaluated cording to the Young criteria.All the patients were followed up for 2 months,and the correlation between the results of CEEG's monitoring and the prognosis of the patients was analyzed.Results: The CEEG of 30 patients with critical cerebral hemorrhage was nearly always markedly abnormal.The occurrence of nonconvulsive seizures was observed in 10% of the patients and convulsive seizures in 3.3%.The unfavorable prognosis rate in the cases with CEEG classification of Ⅰ and Ⅱ was 11.8%,while it was 53.8% in cases with CEEG classification of Ⅲ-Ⅵ.The difference was significant (P=0.019).Conclusions: The CEEG classification is markedly correlated with the prognosis of patients with acute critical cerebral hemorrhage,and CEEG monitoring might be of certain value in predicting the outcome.

       

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