CAJ | 학술논문

目的：探讨视频脑电监测技术对成人痫性发作的鉴别诊断作用。方法采用美国尼高力公司生产的32导程视频脑电仪描记系统，对208例经体检疑诊痫性发作的成人患者进行24 h长程视频头皮脑电监测，通过回放分析患者发作期、发作间期、发作后脑电图表现，分析其阳性及阴性似然比。结果通过临床查体、发作过程观察结合同步脑电图表现以及用药是否有效等手段得出可靠的临床癫痫确诊患者191例，其中脑电图阳性(脑电图上出现尖波、棘波、尖慢波、棘慢波、多棘慢波或快节律等痫性波)者146例，这包括捕捉到发作者104例，这104例患者同步脑电图均出现痫样放电，阴性者45例，非癫痫患者17例，其中脑电图阳性者13例，阴性者4例，这包括出现发作者5例，同步脑电图均未发现痫样放电。阳性似然比为99.9%，阴性似然比为100.0%。208例患者仅通过询问病史，体检而未行脑电图检查，诊断癫痫患者142例，非癫痫患者66例，阳性似然比为86.0%，阴性似然比为88.1%。两组比较差异均有统计学意义(均P<0.05)。结论视频脑电可以有效提高成人痫性发作患者的确诊率，具有重要的临床应用价值。
목적：탐토시빈뇌전감측기술대성인간성발작적감별진단작용。방법채용미국니고력공사생산적32도정시빈뇌전의묘기계통，대208례경체검의진간성발작적성인환자진행24 h장정시빈두피뇌전감측，통과회방분석환자발작기、발작간기、발작후뇌전도표현，분석기양성급음성사연비。결과통과림상사체、발작과정관찰결합동보뇌전도표현이급용약시부유효등수단득출가고적림상전간학진환자191례，기중뇌전도양성(뇌전도상출현첨파、극파、첨만파、극만파、다극만파혹쾌절률등간성파)자146례，저포괄포착도발작자104례，저104례환자동보뇌전도균출현간양방전，음성자45례，비전간환자17례，기중뇌전도양성자13례，음성자4례，저포괄출현발작자5례，동보뇌전도균미발현간양방전。양성사연비위99.9%，음성사연비위100.0%。208례환자부통과순문병사，체검이미행뇌전도검사，진단전간환자142례，비전간환자66례，양성사연비위86.0%，음성사연비위88.1%。량조비교차이균유통계학의의(균P<0.05)。결론시빈뇌전가이유효제고성인간성발작환자적학진솔，구유중요적림상응용개치。
Objective To explore the value of video-electroencephalogram (video EEG, VEEG) monitoring technology in the differential diagnosis for adult epileptic seizure. Methods Two hundred and eight adult patients with suspected seizure underwent 24 hours LTM by 32-way VEEG trace system (American high-power company's product), and then the VEEG recorded data of seizure time, interictal, and afterwards time were reviewed and analyzed to explore the positive and negative likelihood ratios. Results 191 reliable clinical epilepsy patients were confirmed based on physical examination, symptoms during seizure, synchronizing EEG performance, and corresponding medication effects, including 146 cases of positive and 45 cases of negative EEG. Among the patients with positive ECG epileptic wave, such as sharp, spike, sharp complex, spike complex, poly spike complex, or fast rhythm pattern in EEG), 104 cases of paroxysmal patients were all detected with epileptic discharge in synchronizing EEG. Meanwhile, 17 cases of non-epilep-sy (13 positive included 5 seizure patients without epileptic discharge in synchronizing EEG, 4 negative) were observed. The positive and negative likelihood ratios were 99.9%and 100.0%respectively. In another 208 patients, 142 cases of ep-ilepsy and 66 cases of non-epilepsy were diagnosed only by medical history and physical examination without EEG, where the positive and negative likelihood ratios were 86.0%and 88.1%. There was statistical difference between the two groups (P<0.05). Conclusion VEEG can effectively improve the diagnostic rate in adult epileptic patients, which shows an important clinical value.