Attia J, Cook D J
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Crit Care Clin. 1998 Jul;14(3):497-511. doi: 10.1016/s0749-0704(05)70013-0.
This article presents a systematic review of the prognostic factors in coma caused by hypoxia and anoxia, and traumatic head injury. In the case of anoxic coma, poor prognosis can be determined very accurately at the bedside by the lack of brainstem reflexes assessed at day three post-insult. Electroencephalogram (EEG) and evoked potentials (i.e., auditory and somatosensory) detect additional patients with poor prognosis. Clinical examination is not as helpful in the case of traumatic coma. Evoked potentials performed within the first week detect approximately half of patients with a poor prognosis. EEG adds only a small amount of prognostic information.
本文对缺氧、缺血性昏迷以及创伤性颅脑损伤的预后因素进行了系统综述。在缺氧性昏迷的情况下，伤后第三天评估脑干反射缺失可在床边非常准确地判断预后不良。脑电图（EEG）和诱发电位（即听觉和体感诱发电位）可检测出更多预后不良的患者。在创伤性昏迷的情况下，临床检查的作用不大。伤后第一周内进行的诱发电位检查可检测出约一半预后不良的患者。脑电图仅增加少量预后信息。
