摘要
目的·探讨N2O体感诱发电位的连续监测结果对颅脑创伤昏迷患者的预后判断价值。方法·收集35例重型颅脑创伤格拉斯哥昏迷评分(GCS)≤8分昏迷患者的N20诱发电位数据,以N20诱发电位波幅改变、潜伏期延长作为主要观察指标,进行连续监测。除常规固定时间监测外,在急诊血肿清除术后、脑积水术前及术后、GCS评分改变后、腰椎穿刺术前后等进行监测,并结合病情进行观察分析。结果·N2O诱发电位波幅是否存在、潜伏期是否延长与患者治疗过程中的病情密切相关。双侧N20均存在的患者,预后较好;仅一侧N20存在的患者,病情可在较长的时间处于相对稳定状态;双侧N20均消失的患者预后较差。结论·体感诱发电位N20的波幅、潜伏期为重型颅脑创伤昏迷患者在神经重症监护治疗阶段提供一种较为客观、简便的检查方法,可结合干预措施实施的情况为患者提供预后分析。
Objective · To explore the value of continuous monitoring of N20 somatosensory evoked potentials for predicting the prognosis of coma patients with traumatic brain injury. Methods · N20 evoked potential data from 35 patients with severe traumatic brain injury whose Glasgow Coma Scale （GCS） scores were ≤8 points were collected. Continuous monitoring was performed with changes in amplitude and prolonged latency of N20 evoked potential as major monitoring indexes. Apart from routine regular monitoring, monitoring was also performed after emergency hematoma removal, before changes in GCS scores, and before and after hydrocephalus shunt surgery and lumbar puncture procedure. Observation and analysis were conducted in conjunction with patient＇s conditions. Results · The presence of the amplitude of N20 evoked potential and prolonged latency were closely related to patient＇s conditions. The prognosis of patients with presence of bilateral N20 was favorable. Conditions of patients with presence of unilateral N20 were relatively stable for a long period of time. The prognosis of patients with absence of bilateral N20 was poor. Conclusion · The amplitude and latency of somatosensory evoked potential N20 provide an objective and simple monitoring method for coma patients with traumatic brain injury during neurological intensive care, as well as prognosis analysis in conjunction with intervention measures.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2016年第8期1196-1200,共5页
Journal of Shanghai Jiao tong University:Medical Science
基金
上海市教育委员会高峰高原学科建设计划(20152212)~~
关键词
体感诱发电位
N20
颅脑创伤
昏迷
预后
somatosensory evoked potential
N20
traumatic brain injury
coma
prognosis
