大面积脑梗死伴脑水肿患者的定量脑电图检测分析

目的:探讨定量脑电图(qEEG)在大面积脑梗死伴脑水肿患者中的监护应用价值.方法:将大面积脑梗死伴脑水肿30例老年患者作为观察组,选择同期体检老年人30名为对照组,采用Bio-Logic脑电图仪分别检测患者发病6 h内(T₁)、24 h(T₂)、72 h(T₃)、168 h(T₄)的qEEG,检测(δ+θ)波与(α+β)波的比率(DTABR)以及颅内脑水肿体积和美国国立卫生研究院卒中量表(NIHSS)评分,比较在不同病程阶段的变化.结果:入院后观察组DTABR高于对照组(P<0.01);观察组患者治疗中死亡5例,各个病程阶段之间DTABR、脑水肿体积和NIHSS评分的比较结果显示,T₁与T₂差异均无统计学意义(P>0.05),T₃D TABR和脑水肿体积均多于T₁和T₂(P<0.05~P<0.01),而T₄ DTABR脑水肿体积和NIHSS评分均明显少于T₁、T₂与T₃.观察组治愈患者DTABR和NIHSS评分均低于未愈患者(P<0.05~P<0.01).结论:qEEG可客观有效地评价大面积脑梗死伴脑水肿患者脑功能情况,有望成为神经内科重症监护病房床边脑功能评价的重要方法.

Quantitative analysis of electroencephalogram in patients with massive cerebral infarction complicated with cerebral edema

Objective:To investigate the monitoring value of quantitative electroencephalogram(qEEG) in the patients with massive cerebral infarction complicated with cerebral edema. Methods:Thirty elderly patients with massive cerebral infarction complicated with cerebral edema and 30 examination elderly people were divided into the observation group and control group. The qEEG detected by the Bio-Logic electroencephalograph,DTABR,intracranial brain edema volume and National Institutes of Health Stroke Scale( NIHSS) in all patients were compared and analyzed within 6 h(T1),24 h(T2),72 h(T3) and 168 h(T4) of the onset of disease. Results:The DTABR in observation group was higher than that in control group(P<0. 01),5 cases in observation group died during the treatment. The results of DTABR,cerebral edema volume and NIHSS score at each stage showed that the difference of which between T1 and T2 was not statistically significant(P>0. 05). The change trends of DTABR index,NIHSS score and cerebral edema volume were similar, which arrived at the peak after 72 h,and began to decrease with the course of disease alleviating. The DTABR of the cure patients in observation group increased from T1 to T3 ,arrived at the peak,and gradually began to decrease from T3 to T4 ,while the declining trend of DTABR at T3 and T4 in the unhealed patients was not found. Conclusions:The qEEG can objectively and effectively evaluate the brain function in the patients with massive cerebral infarction complicated with cerebral edema,which can be expected to become an important bedside assessment means of brain function in neurological intensive care unit.