[1]詹达词 潘在轩.BSR与BAEP对颅脑损伤后长期意识障碍患者清醒的预测作用[J].中国临床神经外科杂志,2017,(03):149-151.[doi:10.13798/j.issn.1009-153X.2017.03.007]
 ZHAN Da-ci,PAN Zai-xuan..The prediction of awakening by brainstem reflex and BAEP in patients with long-term conscious disturbance after traumatic brain injury[J].,2017,(03):149-151.[doi:10.13798/j.issn.1009-153X.2017.03.007]
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BSR与BAEP对颅脑损伤后长期意识障碍患者清醒的预测作用()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年03期
页码:
149-151
栏目:
论著
出版日期:
2017-03-20

文章信息/Info

Title:
The prediction of awakening by brainstem reflex and BAEP in patients with long-term conscious disturbance after traumatic brain injury
文章编号:
1009-153X(2017)03-0149-03
作者:
詹达词 潘在轩
571300 海南,文昌市人民医院神经外科
Author(s):
ZHAN Da-ci PAN Zai-xuan.
Department of Neurosurgery, The People’s Hospital of Wenchang City, Wenchang 571300, China
关键词:
颅脑损伤长期意识障碍脑干反射脑干听觉诱发电位预测清醒
Keywords:
Traumatic brain injury Long-term conscious disturbance Brainstem reflex Brain-stem auditory evoked potentialPredictive effect Awakening
分类号:
R 651.1+5
DOI:
10.13798/j.issn.1009-153X.2017.03.007
文献标志码:
A
摘要:
目的 探讨脑干反射(BSR)与脑干听觉诱发电位(BAEP)检查对颅脑损伤后长期意识障碍患者清醒的预测效果。方法 2013年8月至2015年9月收治颅脑损伤后长期意识障碍患者75例,均接受BSR及BAEP检查。伤后6个月内清醒42例(清醒组),未清醒33例(未清醒组;包括死亡、植物生存状态)。结果 清醒组BSR分级Ⅰ级18例,Ⅱ级16例,Ⅲ级8例;未清醒组BSR分级Ⅰ级4例,Ⅱ级2例,Ⅲ级14例,Ⅳ级13例;两组BSR分级差异有统计学意义(P<0.05)。将BSR分级Ⅰ级、Ⅱ级作为患者容易清醒的指标,将Ⅲ级、Ⅳ级作为患者难于清醒的指标,其特异度、灵敏度分别为87.50%、81.03%。清醒组BAEP分级Ⅰ级27例,Ⅱ级15例;未清醒组Ⅰ级7例,Ⅱ级17例,Ⅲ级9例;两组BAEP分级差异有统计学意义(P<0.05)。将BAEP分级Ⅰ级作为患者容易清醒的指标,将Ⅲ级作为患者难于清醒的指标,其特异度、灵敏度分别为95.67%、78.13%。结论 对颅脑损伤后长期意识障碍患者采用BSR及BAEP检查,可有效对患者清醒情况进行预测,为临床防治颅脑损伤提供依据。
Abstract:
Objective To investigate the effects of brainstem reflex (BSR) and brainstem auditory evoked potential (BAEP) on prediction of awakening in the patients with long-term conscious disturbance (LTCD) after traumatic brain injury (TBI). Methods Seventy-five patients with LTCD after TBI who treated in our hospital from August, 2013 to September, 2015 served as the objects of study, and all the patients received BSR examination 1, 7, 15, 30, 60 and 120 days after admission to hospital and BAEP examination 7 days after admission to hospital. All the patients were divided into conscious group and unconscious group (including died and persistent vegetative state patients) according to consciousness status six months after the injury. The correlation of BSR and BAEP with patients’ consciousness was analyzed. Results The grades of BSR and BAEP were negatively related to the conscious rate of patients with LTCD after TBI (r=-0.574, -0.667, P=0.008, 0.005). The grade Ⅰ and grade Ⅱ of BSR served as the indicators that patients were likely to awake, and grade Ⅲ, grade Ⅳ as the indicators that patients were unlikely to awake, and their specificity and sensitivity were 87.50% and 81.03% respectively. The grade Ⅰ of BAEP served as the indicators that patients were likely to awake, and grade Ⅲ as the indicators that patients were unlikely to awake and their specificity and sensitivity were 95.67% and 78.13% respectively. Conclusion BSR and BAEP examinations were very helpful to predicting the awakening in patients with LTCD after TBI and provide the basis for clinical treatment of TBI.

参考文献/References:

[1] 韩梦琪,张 皓,张小年,等. 控制性皮质撞击法制备颅脑 创伤后长期认知功能障碍模型的评价[J]. 中华物理医学 与康复杂志,2015,37(1):1-6.
[2] 李之林,杨忠秀,王冀平,等. 全身运动评估、头颅CT和脑 干听觉诱发电位在高危儿脑发育评估中的应用[J]. 中华 行为医学与脑科学杂志,2014,23(3):228-230.
[3] 高国一. 急性颅脑损伤导致昏迷的救治[J]. 中华神经创 伤外科电子杂志,2015,1(6):55-56.
[4] 方 宁,王爱萍,陈 振,等. 体感诱发电位在高压氧治疗 脑外伤意识障碍患者中的作用[J]. 中华航海医学与高气 压医学杂志,2013,20(1):22-24,28.
[5] 伍海青,包 贇,徐伟伟,等. 脑干反射对脑创伤意识障碍 患者预后的预测价值[J]. 中华神经外科疾病研究杂志, 2015,14(2):126-129.
[6] 徐伟伟,王向宇,周月玲,等. 重型颅脑损伤后长期意识障 碍患者的清醒预测及预后评估[J]. 中国临床神经外科杂 志,20009,19(8):476-478.
[7] Luo JJ,Khurana DS,Kothare SV. Brainstem auditory evoked potentials and middle latency auditory evoked potentials in young children [J]. J Clin Neurosci, 2013, 20(3): 383-388.
[8] 蒋熙攘,刘 胜,王 诚,等. 磁敏感加权成像对轻型颅脑 损伤的临床应用及意义[J]. 中国临床神经外科杂志, 2011,26(9):520-523.
[9] 傅圆伟,杨晓明,冯 杰,等. 重型颅脑损伤患者持续意 识障碍的相关因素分析[J]. 中华急诊医学杂志,2015,24 (3):315-319.
[10] Zhang Y, Wang M, Su YY. The role of middle latency evoked potentials in early prediction of favorable outcomes among patients with severe ischemic brain injuries [J]. J Neurol Sci, 2014, 345(1-2): 112-117.

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更新日期/Last Update: 2017-03-25