脑干听觉诱发电位和体感诱发电位对昏迷患者预后的判断

目的脑干听觉诱发电位(BAEP)和体感诱发电位(SEP)与昏迷患者预后密切相关,探讨BAEP和SEP判断昏迷患者脑功能状态的可行性和准确性。方法采用丹麦Dantec公司生产Neuromatic2000型肌电图诱发电位仪。检查ICU病房中36例昏迷患者的BAEP和SEP。BAEP分析III-V波,SEP分析P15、N20、P25波。检查结果分为正常和异常。预后分为好转和死亡。结果36例患者,BAEP正常12例,异常24例。SEP正常13例,异常23例。好转13例,死亡23例。当SEP异常时,死亡率明显高于SEP正常时。而同时伴有BAEP异常时,死亡率更高。14例患者SEP检查P15、N20、P25波均消失,12例死亡,病死率为86%。5例患者BAEP检查III-V波和SEP检查P15、N20、P25波均消失,全部死亡,病死率为100%。结论BAEP和SEP的正常与否与昏迷患者的预后有密切关系(P=0.011)。SEP异常是判定的主要根据。BAEP和SEP相结合,则可以提高判断的准确性。对昏迷患者进行动态的BAEP和SEP观察可提高判断的准确性。

The prognosis value of brainstem auditory evoked potentials and somatosensory evoked potentials for coma

Aim To study the prognosis value of BAEP a nd SEP for the coma.Methods Examination was performed with Neur omatic 2000electromyograph producted by Dante c.BAEP was analysised III-V and SEP was analysised P15,N20,P25.The result was normal and abnor-mal.The prognosis was improvement a nd death.Results In 36patients,12patients were BAEP normal and 24we re abnormal.13patients were normal SEP and 23were abnormal.The mortality of patients with abnormal SEP was higher than that with normal S EP.When BAEP was abnormal at the same time,the mortality was little higher than that with abnormal SEP only.14patients did not have record able P15,N20,P25and 12patients died.5patients did not have recordable III-V at the same time,all of them died.Conclusion BAEP and SEP have osculate relationship with the prognosis of the coma (P=0.011).SEP is major.The moving examina-tion can improve accuracy.poten-tials,somatosensory;coma;prognosis