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目的探讨长程脑电图监测和临床检测指标对评估昏迷患者预后的应用价值。方法对26例昏迷患者(男15例,女11例,年龄17～90岁)急性期进行长程脑电图监测、改良 Glasgow 昏迷评分以及半球复杂性的分析,随访患者至昏迷后2个月.并进行 Glasgow 预后评分,将长程脑电图监测和临床检测指标结果和昏迷患者预后进行相关分析;观察昏迷患者半球复杂性随时间的变化及其与预后的关系。结果长程脑电图监测对昏迷患者预后评估的特异度(77.8%)、准确度(92.3%)均较临床检测指标改良 Glasgow 昏迷评分高。脑电图分级与 Glasgow 预后评分进行线性相关分析,相关系数r=0.81,P<0.01;改良 Glasgow 昏迷评分和 Glasgow 预后评分进行线性相关分析,相关系数r=-0.39,P<0.01。患者病情变化时,脑电图改变出现在改良 Glasgow 昏迷评分改变之前。所观察的全部26例昏迷患者其左、右半球复杂性的熵值差异均无统计学意义,熵值随时间的变化呈6种图形,其中4种图形的昏迷患者 Glasgow 预后评分指标不良;2种图形的患者预后指标良好。结论对昏迷患者进行长程脑电图监测,在评价脑功能和预测昏迷患者的预后两方面有较好的应用价值。
Objective To investigate the long-term EEG monitoring and clinical testing indicators for assessing the prognosis of patients with coma prognosis. Methods Long-range EEG monitoring, modified Glasgow coma score and hemispheric complexity were analyzed in 26 coma patients (15 males and 11 females, aged 17-90 years). The patients were followed up for 2 months after coma. And Glasgow prognostic score, the long-range EEG monitoring and clinical test results and coma prognosis of patients with coma correlation analysis; observe coma patients hemispheric complexity over time and its relationship with prognosis. Results Long-range EEG monitoring had a higher specificity (77.8%) and accuracy (92.3%) than the modified Glasgow coma score in coma patients. The linear correlation analysis between EEG grading and Glasgow prognostic score showed that the correlation coefficient was 0.81 (P <0.01). Correlation coefficient was -0.39 between the improved Glasgow coma scale and the Glasgow prognostic score (r = -0.39, P <0.01). When the patient’s condition changes, EEG changes occur before the modified Glasgow coma score changes. There was no significant difference in the entropy of the left and right hemispheres in all 26 coma patients observed. There were 6 patterns in the change of entropy with time, among which, the Glasgow prognostic score of 4 coma patients was poor. 2 The kind of patient’s prognosis is good. Conclusion Long-range electroencephalogram monitoring of coma patients has good value in evaluating brain function and prognosis of patients with coma.