摘要: |
[摘要] 目的 探讨幕上自发性脑出血合并昏迷患者术后脑电监测对预后评估的价值。方法 收集重庆医科大学附属第三医院2016年4月至2020年4月神经疾病科重症监护室发病72 h内的幕上自发性脑出血合并昏迷并行急诊血肿清除术患者136例,术后14 d行床旁视频脑电监测并分析脑电图(EEG)特征,术后90 d通过扩展的格拉斯哥预后评分(GOS-E)评估预后。结果 136例患者中69例(50.7%)预后良好,67例(49.3%)预后不良。logistic回归分析显示,血肿体积较大(OR=6.450,95%CI:3.018~13.783)、EEG Young分级较高(OR=2.516,95%CI:1.804~3.510)、EEG无反应性(OR=2.167,95%CI:1.091~4.303)、无睡眠波(OR=3.040,95%CI:1.319~7.006)提示预后不良;格拉斯哥昏迷量表(GCS)评分得分越高(OR=0.549,95%CI:0.242~1.246)提示预后越好。结论 脑电监测可作为幕上自发性脑出血昏迷患者急诊血肿清除术后预后的评估参考指标。 |
关键词: 脑出血 脑电图 昏迷 预后 |
DOI:10.3969/j.issn.1674-3806.2021.08.17 |
分类号:R 743.34 |
基金项目: |
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The value of electroencephalogram monitoring for prognosis evaluation in patients with spontaneous supratentorial hemorrhage complicated with coma receiving emergency hematoma removal surgery |
DENG Chun-yan, WANG Yu-tao, LIU Jiang, et al.
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Neurological Disease Center, the Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, China
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Abstract: |
[Abstract] Objective To investigate the value of postoperative electroencephalogram(EEG) monitoring for prognosis evaluation in patients with spontaneous supratentorial hemorrhage complicated with coma. Methods One hundred and thirty-six patients with spontaneous supratentorial hemorrhage complicated with coma within 72 hours and receiving emergency hematoma removal surgery in the Intensive Care Unit of the Department of Neurological Diseases in the Third Affiliated Hospital of Chongqing Medical University from April 2016 to April 2020 were collected. The bedside video EEG monitoring was performed 14 days after operation and the EEG characteristics were analyzed. The patients′ prognoses were assessed by Extended Glasgow Outcome Score(GOS-E) 90 days after operation. Results Of the 136 patients, 69 patients(50.7%) had a good prognosis and 67 patients(49.3%) had a poor prognosis. Logistic regression analysis showed that larger hematoma volume(OR=6.450, 95%CI: 3.018-13.783), higher EEG Young classification(OR=2.516, 95%CI: 1.804-3.510), EEG non-responsiveness(OR=2.167, 95%CI: 1.091-4.303), and no sleep wave(OR=3.040, 95%CI: 1.319-7.006) indicated a poor prognosis. The higher the Glasgow Coma Scale(GCS) score(OR=0.549, 95%CI: 0.242-1.246), the better the prognosis. Conclusion EEG monitoring can be used as a reference index to evaluate the postoperative prognosis of patients with spontaneous supratentorial hemorrhage complicated with coma receiving emergency hematoma removal surgery. |
Key words: Cerebral hemorrhage Electroencephalogram(EEG) Coma Prognosis |