CAJ | 학술논문

目的通过观察电脉冲体感诱发电位(somatosensory evoked potentials,SEPs)的存在与否,对SEPs预测高压氧治疗脑外伤伴意识障碍患者预后的价值作评价.方法 49例脑外伤(TBI)患者,依据SEPs存在与否分为2组,用JFK昏迷恢复量表修订版(coma recovery scale-revised,CRS-R)评分及临床意识状态临床诊断判断治疗效果.2组患者均给予脱水、促醒、活血化瘀、营养神经细胞、高压氧及康复理疗.结果 SEPs存在者神志恢复清醒率临床意识状态诊断法为52.5％ (21/40),CRS-R评价法为47.5％ (19/40),显著优于双侧SEPs缺失者(P＜0.01)；双侧SEPs缺失者无一例神志恢复清醒.结论 (1)双侧SEPs缺失对预测不能苏醒具有重要的意义,可作为预测预后不佳的独立因素.(2)SEPs存在者预后和治疗结果显著优于SEPs缺失者.
목적 통과관찰전맥충체감유발전위(somatosensory evoked potentials,SEPs)적존재여부,대SEPs예측고압양치료뇌외상반의식장애환자예후적개치작평개.방법 49례뇌외상(TBI)환자,의거SEPs존재여부분위2조,용JFK혼미회복량표수정판(coma recovery scale-revised,CRS-R)평분급림상의식상태림상진단판단치료효과.2조환자균급여탈수、촉성、활혈화어、영양신경세포、고압양급강복리료.결과 SEPs존재자신지회복청성솔림상의식상태진단법위52.5％ (21/40),CRS-R평개법위47.5％ (19/40),현저우우쌍측SEPs결실자(P＜0.01)；쌍측SEPs결실자무일례신지회복청성.결론 (1)쌍측SEPs결실대예측불능소성구유중요적의의,가작위예측예후불가적독립인소.(2)SEPs존재자예후화치료결과현저우우SEPs결실자.
Objective To evaluate the importance of somatosensory evoked potentials (SEPs)in the assessment of prognosis of patients with traumatic brain injury (TBI) coupled with disorder of consciousness,following the treatment of hyperbaric oxygen (HBO),through observing whether there were SEPs in them.Methods Forty-nine cases of TBI coupled with conscious disorder were divided into 2 groups,depending on whether there were SEPs in them.Effects of treatment were assessed by using the JFK Coma Recover Scale-Revised (CRS-R) and the clinical diagnosis of consciousness.Both groups were aggressively treated with dehydration,arousing from the state of unconsciousness,promoting blood circulation to remove stasis,nutrition of nerve cells,HBO therapy and rehabilitation therapy.Results Conscious recovery rate for the patients with positive SEPs was obviously superior to those with bilaterally negative SEPs patients (P ＜ 0.01).None of the cases with bilaterally negative SEPs returned to consciousness.Conclusions (1) Bilaterally negative SEPs are of great significance for predicting whether trauma patients will come to consciousness,which can be taken as an independent factor for predicting clinical prognosis of TBI patients coupled with conscious disorder.(2) The prognosis and outcome of patients with positive SEPs are obviously superior to those patients with negative SEPs.