目的 探讨床旁持续脑电监测(CEEG)对危重孕产妇患者脑功能变化的预警及对预后的评估价值.方法 采用前瞻性研究方法,对43例危重孕产妇行CEEG,连续监测时间>6 h.采用GCS及急性生理与慢性健康评分-Ⅱ(APACHE-Ⅱ)评价患者的病情严重程度.结果 患者GCS评分随CEEG级数升高而降低,APACHE-Ⅱ评分逐级升高.与Ⅰ级患者比较,Ⅲ、Ⅳ、Ⅴ级患者GCS评分显著降低,APACHE-Ⅱ显著增高(P<0.05~0.01).与Ⅱ级患者比较,Ⅲ、Ⅳ、Ⅴ级患者GCS评分显著降低,Ⅴ级患者APACHE-Ⅱ显著增高(P<0.05~0.01).与Ⅲ级患者比较,Ⅴ级患者GCS评分显著降低(P<0.05).CEEG分级与GCS评分呈负相关(r=-0.944,P<0.001).CEEG分级与APACHE-Ⅱ呈正相关(r=0.824,P<0.001).与EEG良好组比较,EEG不良组GCS评分显著降低(P<0.05).结论 CEEG可准确评估危重孕产妇的病情严重程度、判断预后.%Objective To discuss the clinic value of continuing bedside electroencephalogram ( CEEG ) on evaluating cerebral dysfunction change and prognosis in critically ill obstetric patients. Methods A prospective research method was adopted, 43 critically ill obstetric patients were given CEEG, continuous monitoring time>6 h. The severity degree of condition was evaluated by GCS and Acute Physiology and Chronic Health Evaluation-Ⅱ( APACHE-II) . Results The GCS score of patients decreased with the increase of CEEG series, while APACHE-Ⅱscore increased step by step. Compared with the Ⅰ level patients, the GCS scores of Ⅲ, Ⅳ and Ⅴ levels patients were significantly decreased, APACHE-Ⅱ of Ⅴ level patients was significantly increased (P<0.05 -0. 01). Compared with the Ⅱ level patients, the GCS scores of Ⅲ, Ⅳ and Ⅴ level patients were significantly decreased, APACHE-Ⅱ of Ⅴ level patients was significantly increased (P<0. 05 -0. 01). Compared with the Ⅲ level patients, the GCS scores of Ⅴ level patients was significantly decreased (P<0. 05). CEEG grading and negatively correlated with GCS score (r= -0. 944, P<0. 001). CEEG classification with APACHE-II scores were positively correlated (r=0. 824, P<0. 001). Compare with the good EEG group, the bad EEG group of patients with GCS significantly decreased ( P<0. 05 ) . Conclusion CEEG monitoring can accurately assess the severity degree of condition and outcome evaluation in obstetric patients.
展开▼
