CAJ | 학술논문

目的探讨脑干听觉诱发电位(BAEP)分级标准对脑创伤后长期意识障碍患者清醒预测的价值.方法分析93例脑创伤后长期意识障碍患者的BAEP表现,将BAEP分为3级:Ⅰ级为各波均正常；Ⅲ级为双侧V波PL异常、双侧Ⅲ～Ⅴ波IPL异常、单侧或双侧V波消失；Ⅱ级为除Ⅲ级之外的任何异常BAEP表现.以脑创伤后6个月作为判断是否清醒的时间标准.结果 Ⅰ级、Ⅱ级、Ⅲ级的清醒率分别为:79％、18％和0％.分级与清醒差异有统计学意义(r=-0.662,P＜0.001),分级越高,清醒越困难.BAEP分级标准对清醒预测的ROC曲线下面积为0.859,95％可信区间为(0.781～0.937).结论 BAEP分级能客观、准确地反映脑功能损伤程度和预测清醒的概率.
목적 탐토뇌간은각유발전위(BAEP)분급표준대뇌창상후장기의식장애환자청성예측적개치.방법 분석93례뇌창상후장기의식장애환자적BAEP표현,장BAEP분위3급:Ⅰ급위각파균정상；Ⅲ급위쌍측V파PL이상、쌍측Ⅲ～Ⅴ파IPL이상、단측혹쌍측V파소실；Ⅱ급위제Ⅲ급지외적임하이상BAEP표현.이뇌창상후6개월작위판단시부청성적시간표준.결과 Ⅰ급、Ⅱ급、Ⅲ급적청성솔분별위:79％、18％화0％.분급여청성차이유통계학의의(r=-0.662,P＜0.001),분급월고,청성월곤난.BAEP분급표준대청성예측적ROC곡선하면적위0.859,95％가신구간위(0.781～0.937).결론 BAEP분급능객관、준학지반영뇌공능손상정도화예측청성적개솔.
Objective To explore the value of new brainstem auditory evoked potential grading in prediction of awakening in unconscious patients after traumatic brain injury ( TBI ).Method BAEPs were recorded and analyzed in 93 patients suffering from TBI with duration of disturbance of unconsciousness.BEAPs were classified into three grades:Gradel-all BEAP findings were normal;Grade Ⅲ -bilateral PL of wave Vor IPL of wave Ⅲ ～ Ⅴ were abnormal,unilateral or bilateral wave Ⅴ were absent;Grade Ⅱ- any abnormal BAEPs except Grade Ⅲ,including unilateral or bilateral peak latency(PL) of waveⅠ,Ⅲ,inter peak latency(IPL) of wave Ⅰ ～ Ⅲ or amplitude ratio of waveⅠand Ⅴ were abnormal,or unilateral PL of wave Ⅴ or IPL of wave Ⅲ ～ Ⅴwere abnormal.Conscious or unconscious at the 6th month after injury was considered as the outcome criterion.Results The new grading standards showed grade Ⅰ,Ⅱ and Ⅲ have 79％,18％ and 0％ of patients awaking at the 6th month.The new BAEP grading standards had significant correlation with the probabilities of awakening( r =-0.662,P ＜0.001 ; The higher the grades,the lower the probability of awakening).The area under the ROC curve was 0.859 and 95％ confidence interval was (0.781 ～ 0.937 ) of awakening prediction using BAEP classification standard.Conclusions New BAEP grading could demonstrate cerebral dysfunction and probabilities of patients' awakening objectively and accurately.