脓毒症脑病患者脑血流速度和脑电活动变化及临床意义

摘要

Objectiye:To investigate changes and clinical significances of cerebral blood flow velocity and brain electric activity in patients with sepsis associated encephalopathy. Method:All people were classified into three groups:control group,sepsis without encephalopathy group and sepsis associated encephalopathy group. The cerebral blood flow velocities were examined by TCD and compared among three groups;the brain electric activities were monitored by EEG and com-pared among three groups. Results:The cerebral blood flow velocity was significantly slower in sepsis associated encepha-lopathy group than in the other two groups( < 0. 05). The alpha wave was significantly lower and deta wave was signifi-cantly higher in sepsis associated encephalopathy group than in the other two groups( < 0. 05);the P1 wave was signifi-cantly shortened and latent period of S-P1、N1-P2 was significantly longer in sepsis associated encephalopathy than in the other two groups( < 0. 05),but there was no significant change in P1-N1( > 0. 05). Conclusion:The test of cerebral blood flow velocity and monitoring of brain electricity is very valuable for diagnosing and treating with sepsis associated encephalopathy.%目的：探讨脓毒症脑病患者脑血流速度、脑电活动的变化及临床意义。方法：60例患者分为脓毒症无脑病组与脓毒症脑病组，另取18例门诊自愿者为对照组。患者采用经颅多普勒超声（TCD）检测和比较各组患者平均脑血流速度（Vm）、搏动指数（PI）、阻力指数（RI）；采用脑电图及体感诱发电位监测和比较各组患者脑电活动的变化。结果：脓毒症脑病组患者平均脑血流速度明显低于脓毒症无脑病组、对照组，差异均有显著性（<0.05）；脓毒症脑病组患者脑电图中α波较对照组和脓毒症无脑病组明显下降，δ波明显增加，各组比较差异有显著性（<0.05）；脓毒症脑病组与对照组、脓毒症无脑病组相比，P1振幅明显下降，S O P1及 N1 O P2潜伏期明显延长，各组比较差异有显著性（<0.05），P1 O N1无明显改变（>0.05）。结论：脓毒症脑病患者脑血流速度的检测及脑电活动变化监测对早期发现脓毒症脑病具有重要的客观指导意义。