首页> 中文期刊>中华神经外科杂志 >定量脑电图对重型颅脑创伤长期意识障碍患者的清醒评估

定量脑电图对重型颅脑创伤长期意识障碍患者的清醒评估

摘要

Objective To explore the quantitative electroencephalography in unconscious patients after severe traumatic brain injury (TBI) to predict awakening.Method All cases were divided into two groups( the awake group 19 cases and the unfavourable prognosis group 22 cases).Two weeks after admission the original EEGs were preformed in 41 patients suffering from severe TBI with duration of disturbance of unconsciousness ≥2 weeks.The sampled data did make fast Fourier transform to obtain the power spectrum analysis with the computer software.The power spectrum was divided into 6 bandwidth by frequency: δ( 1.0~4.0 Hz)、θ(4.1 ~8.0 Hz) 、α1(8.1 ~10.0 Hz) 、α2(10.1 ~13 Hz) 、β1 (13.1 ~17.5 Hz) 、β2(17.6 ~35.0 Hz).Calculate the absolute power value in each band and δ + θ/β + β value and research the correlation of the both group.The awakening after the sixth months from injury was used as the criterion.Results The score of δ + θ/α + β was 5.432 ± 3.277 in the awake group,yet in the unfavourable prognosis group was 8.724 ± 5.641.Using the two independent sample t test, both groups had significant difference, t =2.237 ( P = 0.030 ).Using Pearson correlation analysis, r = - 0.622, P = 0.004, both Glasgow coma score and δ + θ/α + β value had negative correlation.Conclusions As an inexpensive,objective and rapid means of the evaluation of brain function,the QEEG can accurately reflect the degree of brain dysfunction and assess the prognosis of patients.%目的 探讨定量脑电图在重型颅脑创伤后长期意识障碍患者预后中的应用.方法 收集我院重型颅脑创伤意识障碍超过2周的患者41例,分成清醒组(19例)和未清醒组(22例),均于入院后2周行脑电图检查获取原始脑电图资料,采样后借助计算机软件行快速傅里叶转换进行功率谱分析,功率谱按频率分为δ(1.0~4.0 Hz)、θ(4.1~8.0 Hz)、α1(8.1~10.0 Hz)、α2(10.1~13 Hz)、β1(13.1~17.5 Hz)、β2(17.6~35.0 Hz)6个频带,计算出各个频带的绝对功率值及δ+θ/α+β值并以δ+θ/α+β值作为患者顸后评判指标,进行两个病例组之间的关系研究,以颅脑创伤后6个月患者是否清醒为标准.结果 清醒组的6+θ/α+β值((-x)±s)为5.432±3.277,未清醒组的δ+θ/α+β值((-x)±s)为8.724±5.641.清醒组和末清醒组行两独立样本t检验,两组病例间差异有统计学意义,t=2.237(P=0.030).清醒患者的GCS评分和δ+θ/α+β值行Pearson相关分析,得出r=-0.622,P=0.004,两者呈负相关.结论 定量脑电图作为一种廉价、客观、快速的脑功能评价手段,可准确地反映颅脑创伤程度和预后.

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