Häkkinen V K, Kaukinen S, Heikkilä H
Department of Clinical Neurophysiology, Tampere University Central Hospital, Finland.
Int J Clin Monit Comput. 1988;5(2):97-101. doi: 10.1007/BF02919650.
We have studied 20 comatose intensive care patients with head injuries and/or intracranial haemorrhage in order to compare two different monitoring methods of the central nervous system. The level of unconsciousness was followed on the Glasgow Coma Scale (GCS). EEG was monitored continuously with the compressed spectral array (CSA)-method. CSA findings were classified into six categories according to the frequency content, reactivity and the amount of isoelectricity. The patients were divided into four groups according to the outcome: well-recovered, moderately recovered, poorly recovered and dead. The prognostic value of the data obtained with the GCS method was compared with that obtained by CSA. The CSA and GCS methods give information based on different neurophysiological backgrounds. This explains why the correlation of these methods was only moderate. When combining the information received from these two methods the predictability improved. In many acute situations CSA gave information about changes in the brain function, which could not be seen in GCS. The results suggest that CSA is not only a supplementary method to GCS but also a different approach to the monitoring of an unconscious patient.
我们研究了20名患有头部损伤和/或颅内出血的昏迷重症监护患者,以比较两种不同的中枢神经系统监测方法。采用格拉斯哥昏迷量表(GCS)跟踪昏迷程度。使用压缩谱阵(CSA)法连续监测脑电图。根据频率成分、反应性和等电位量,将CSA结果分为六类。根据结果将患者分为四组:恢复良好、中度恢复、恢复不佳和死亡。将GCS法获得的数据的预后价值与CSA法获得的数据的预后价值进行比较。CSA和GCS方法基于不同的神经生理背景提供信息。这就解释了为什么这两种方法的相关性仅为中等。当结合从这两种方法获得的信息时,可预测性提高。在许多急性情况下,CSA提供了关于脑功能变化的信息,而这些信息在GCS中无法看到。结果表明,CSA不仅是GCS的补充方法,也是监测昏迷患者的一种不同方法。