Objective: Having an evaluation and prediction of prognosis to brain function in patients with coma through portable Dynamic electroencephalogram monitoring as well as using such instrument to show a new, simple and efficient method that can be implemented by bed. .Methods: having dynamic brain function monitoring including Glasgow coma scale , GCS and monitoring to 120 coma patients to evaluate the brain func tion of patients: and having correlated analysis with actual prognosis of outcomes in patients together with prognosis evaluation through 3 months following up. Results: Brain function injury serious degree by light to heavy of EEG mode in order to rhythm, and lost rhythm, and three phas1e wave, and Council focal sexual epilepsy sample wave, and Alpha coma, and outbreak suppression, and full suppression; EEG classification and GCS scoring was negative related, above third level indicate the prognosis was bad, however, by same EEG classification, Electroencephalo grapnic reactivity in patients with good prognosis is well than non reactive ones.Conclusion: single-EEG can more accurately determine the degree of impairment of brain function in patients with coma, but not very accurate predic tion of prognosis, but dynamic electroencephalogram monitoring of continuous bedside can observe EEG patterns and reactivity dynamically as well as electroencephalography grading evolution, Basing on variational trend to evaluate the outcomes of the prognosis of patients, the prognosis can be more accuratelyjudged and the results will be more relia ble.%目的:探讨便携式脑电图床边动态监测昏迷患者脑功能状态在临床的应用,以期提供一种新的、简便有效的脑功能评估方法.方法:对120例昏迷病人进行动态脑功能监测:包括行格拉斯哥昏迷量表评分(GCS)和持续床旁脑电图动态监测,评估患者的脑功能状态;随访3个月,结合患者的结局进行相关性分析,进行预后评估.结果:反映脑功能损伤严重程度由轻到重的脑电图模式依次为:δ节律、失节律、三相波、局灶性癫痫样波、α昏迷、爆发-抑制、全面抑制;脑电图分级与GCS 评分呈负相关,Ⅲ级以上时预示预后不良;相同脑电图分级下,脑电图反应性良好的患者其预后较无反应性者好.结论:单次脑电图监测可以较准确地判断昏迷患者的脑功能损害程度,但不能非常准确的预测预后,而连续床旁动态脑电图监测可动态观察脑电图模式及其反应性、脑电图分级的演变,根据其变化趋势评价患者的预后结局,结果更可靠,可以更准确地判断预后.
展开▼
