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脑创伤后长期意识障碍患者脑干听觉诱发电位表现与预后清醒的关系
  • ISSN号:1671-8925
  • 期刊名称:《中华神经医学杂志》
  • 时间:0
  • 分类:R651.15[医药卫生—临床医学;医药卫生—外科学]
  • 作者机构:[1]南方医科大学珠江医院神经外科,广州510282, [2]广东神经医学研究所,广州510282, [3]广东脑功能修复与再生重点实验室,广州510282, [4]广东神经内科脑电图室,广州510282
  • 相关基金:国家自然科学基金(30500526)
中文摘要:

目的 探讨重型创伤性颅脑损伤(TBl)后长期意识障碍患者脑十听觉诱发电位(BAEP)表现与预后清醒的关系。方法 分析63例重型TBI后意识障碍超过2周患者的BAEP表现,主要为BAEP中Ⅰ、Ⅲ、Ⅴ波各波峰潜伏期(PL),Ⅰ~Ⅲ、Ⅲ~Ⅴ波峰间潜伏期(LPL)及Ⅰ波与Ⅴ波波幅比。预后以TBI后6个月患者是否清醒为标准,分为清醒组与未清醇组,组间运用两独市样本t检验以筛选出有意义的指标。结果 本组患者清醒率为34.9%(22/63),BAEP指标异常焉夏为66.7%(42/63)。双侧Ⅰ、Ⅲ、Ⅴ波PL,Ⅰ~Ⅲ波、Ⅲ~Ⅴ波IPL及Ⅰ/Ⅴ波幅比均正常的21例中有16例清醒(清醒率为76.2%),双侧Ⅴ波PL异常的8例及双侧Ⅲ~Ⅴ波IPL异常的7例均未清醒.单侧Ⅴ波消失的2例未清醒。清醒组与未清醒组间比较发现双侧差异均有统计学意义的指标为Ⅴ波PL及Ⅲ~Ⅴ波IPL。结论 BAEP的Ⅴ波PL及Ⅲ~Ⅴ波IPL变化可客观、准确地反映脑损伤的程度及预测患者的预后。

英文摘要:

Objective To explore the correlation between brainstem auditory evoked potential (BAEP) findings and outcome in long-term unconscious patients with severe traumatic brain injury (TBI). Methods BAEP findings were recorded and analyzed in 63 patients suffering from severe TBI with duration of disturbance of unconsciousness for more than 2 weeks. The peak latency (PL) of wave Ⅰ, Ⅲ and Ⅴ, the interpeak latency (IPL) of wave Ⅰ-Ⅲ and Ⅲ-Ⅴ and the amplitude ratio of wave I and V were analyzed. Conscious or unconscious at 6 months after the injury was considered as the outcome criterion, and based on these, the patients were divided into conscious and unconscious groups; the significant indicators were chosen in the 2 groups using independent-sample t test. Results The probabilities of awakening in these patients were 34.9% (22/63) with abnormal index of BAEP indicators reaching 66.7%. Sixteen patients were sober at last in 2l patients with normal PL of wave Ⅰ, Ⅲ and Ⅴ, IPL of wave Ⅰ-Ⅲ and Ⅲ-Ⅴ, and amplitude ratio of wave Ⅰ and Ⅴ in bilateral side (the probabilities of awakening were 76.2%); 8 patients having abnormal PL of wave Ⅴ in bilateral side and 7 having abnormal IPL of wave Ⅲ-Ⅴ in bilateral side were unconscious; 2 patients having disappeared wave Ⅴ in unilateral side were unconscious. PL of wave Ⅴ and IPL of wave Ⅲ-Ⅴ in bilateral side were significantly different between the conscious group and the unconscious group. (P〈0.05). Conclusion BAEP findings (PL of wave Ⅴ and IPL of wave Ⅲ-Ⅴ in bilateral side) can objectively and accurately demonstrate the cerebral dysfunction and predict the outcome of the patients.

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期刊信息
  • 《中华神经医学杂志》
  • 北大核心期刊(2011版)
  • 主管单位:中华人民共和国卫生部
  • 主办单位:中华医学会
  • 主编:
  • 地址:广东省广州市工业大道中253号
  • 邮编:510282
  • 邮箱:Journal@126.com
  • 电话:020-61643273
  • 国际标准刊号:ISSN:1671-8925
  • 国内统一刊号:ISSN:11-5354/R
  • 邮发代号:46-251
  • 获奖情况:
  • 国内外数据库收录:
  • 美国化学文摘(网络版),中国中国科技核心期刊,中国北大核心期刊(2008版),中国北大核心期刊(2011版),中国北大核心期刊(2014版)
  • 被引量:16608