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[早期听觉和体感诱发电位在巴比妥类药物治疗昏迷监测及预后评估中的价值——与临床情况及脑电图的比较]

[Value of early acoustic and somatosensory evoked potentials in monitoring and prognostic assessment of coma in barbiturate therapy--comparison with clinical aspects and EEG].

作者信息

Reisecker F, Witzmann A, Löffler W, Leblhuber F, Deisenhammer E, Valencak E

出版信息

EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1987 Mar;18(1):36-42.

PMID:3106004
Abstract

25 comatose patients suffering from severe cerebral lesions of different etiology were examined during barbiturate-therapy by Glasgow-Pittsburg-Coma-Scoring-System (GPCS), EEG, somatosensory and brainstem acoustic evoked potentials. The findings were correlated in view of prognostic prediction and importance for monitoring. A modified form of the Glasgow-Outcome-Score (GOS; independent-survival, dependent-survival, dead) was used for evaluating the outcome. In case of an initial GPCS less than 10 points none of the patients survived, in case of GPCS greater than 10 points 11 out of 19 patients survived. The latter relation of survival was also found in patients with improving or impairing scores during the observation period. In case of initial burst-suppression pattern in the EEG 7 out of 11 patients survived, in case of diffuse abnormalities with or with-out additional focal signs - 4 out of 10 patients survived, but in the latter there was none with an outcome of independent survival. All patients with an isoelectric EEG died. In case of bilateral recording of scalp- SEP 7 out of 11 patients survived, in case of unilateral loss of scalp-EP 4 out of 8 patients survived, but in the latter cases none with an outcome of independence. All patients with initial bilateral failure of scalp-SSEP or loss during the observation period died. In case of bilateral registrable BAEP (wave I to V) 11 out of 17 patients survived. All patients with initial uni- or bilateral failure of those potentials or loss during the observation period died.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对25例因不同病因导致严重脑损伤的昏迷患者在巴比妥类药物治疗期间,采用格拉斯哥 - 匹兹堡昏迷评分系统(GPCS)、脑电图(EEG)、体感诱发电位和脑干听觉诱发电位进行检查。从预后预测及监测的重要性角度对检查结果进行关联分析。采用改良版格拉斯哥预后评分(GOS;独立生存、依赖生存、死亡)来评估预后。初始GPCS小于10分的患者无一存活,初始GPCS大于10分的19例患者中有11例存活。在观察期内评分改善或恶化的患者中也发现了后者的存活关系。脑电图初始出现爆发抑制模式的11例患者中有7例存活,脑电图出现弥漫性异常伴或不伴有附加局灶性体征的10例患者中有4例存活,但后者无一例获得独立生存的预后。所有脑电图呈等电位的患者均死亡。双侧记录头皮体感诱发电位(SEP)的11例患者中有7例存活,单侧头皮诱发电位消失的8例患者中有4例存活,但后一种情况无一例获得独立生存的预后。所有初始双侧头皮体感诱发电位缺失或在观察期内消失的患者均死亡。双侧可记录到脑干听觉诱发电位(波I至V)的17例患者中有11例存活。所有初始这些电位单侧或双侧缺失或在观察期内消失的患者均死亡。(摘要截取自250字)

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