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[脑电图在严重缺氧性脑损伤中与诱发电位相比的预后地位]

[The prognostic place of EEG in comparison with evoked potentials in severe hypoxic brain damage].

作者信息

Beltinger A, Riffel B, Stöhr M

机构信息

Neurologische Klinik und klinische Neurophysiologie im Zentralklinikum Augsburg.

出版信息

EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1992 Jun;23(2):75-81.

PMID:1505440
Abstract

This retrospective study comprises 34 patients, who died due to the cerebral damage caused by severe anoxia, who were assessed by EEG and AEP or SEP on the same day and in whom at least one of these electrophysiological methods indicated a fatal prognosis. EEG-findings identified 76% of patients with fatal outcome, whereas SEP reliably predicted the outcome in 93% of patients, who died of the cerebral anoxia. In some patients centrally acting drugs made EEG-based but not SEP-based prognosis impossible. In some cases of fatal brain damage, however, only the EEG-findings as opposed to SEP-findings predicted the fatal outcome. Thus the combined assessment by EEG and SEP appears to be optimal in the assessment of an early prognosis. The BAEP were of less prognostic value than the EEG. BAEP findings indicating a fatal outcome were to be found mainly in final clinical stages with loss of brainstem function, whereas EEG as well as SEP identified a considerable number of fatal cases in spite of comparably favourable clinical findings. The evaluation of early electrophysiological testing done within the first 3 days after the anoxic event results in an identical estimation of the prognostic significance of EEG versus BAEP- or SEP-findings, respectively.

摘要

这项回顾性研究包括34例因严重缺氧导致脑损伤而死亡的患者,这些患者在同一天接受了脑电图(EEG)以及听觉诱发电位(AEP)或体感诱发电位(SEP)检查,且这些电生理检查方法中至少有一项显示预后不良。EEG检查结果能识别出76%预后不良的患者,而SEP能可靠地预测93%死于脑缺氧患者的预后。在一些患者中,中枢性药物使得基于EEG而非基于SEP的预后判断无法进行。然而,在一些致命性脑损伤病例中,只有EEG检查结果而非SEP检查结果能预测致命结局。因此,EEG和SEP联合评估似乎是早期预后评估的最佳方法。脑干听觉诱发电位(BAEP)的预后价值低于EEG。提示预后不良的BAEP检查结果主要出现在脑干功能丧失的临床终末期,而EEG和SEP在临床症状相对较好的情况下也能识别出相当数量的致命病例。对缺氧事件后3天内进行的早期电生理检查评估结果显示,EEG与BAEP或SEP检查结果的预后意义评估相同。

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