CAJ | 학술논문

目的评价连续性视频脑电图(cVEEG)监测在重症监护病房(ICU)意识障碍患者中的应用价值.方法回顾性分析54例2008年1月至2014年4月应用cVEEG在北京大学人民医院ICU意识障碍患者临床诊断与鉴别诊断和临床转归中的应用.结果在54例意识障碍患者中,最常见的病因为脑血管病(46.3％),其次是心肺复苏术后(18.5％).cVEEG显示,49例(90.7％)首次背景异常,19例(35.2％)可见癫痫放电,8例(14.8％)诊断为非惊厥性癫痫持续状态(NCSE);在6例因抽搐疑似癫痫的患者中,仅1例同期cVEEG显示癫痫放电;表现为电静息、广泛性低电压、爆发-抑制、弥漫性θ波背景、持续性弥漫性癫痫放电、周期波者病死率高.结论脑血管意外是本组意识障碍患者的主要原因,cVEEG有利于临床诊断与鉴别诊断及患者预后评估.
목적 평개련속성시빈뇌전도(cVEEG)감측재중증감호병방(ICU)의식장애환자중적응용개치.방법 회고성분석54례2008년1월지2014년4월응용cVEEG재북경대학인민의원ICU의식장애환자림상진단여감별진단화림상전귀중적응용.결과 재54례의식장애환자중,최상견적병인위뇌혈관병(46.3％),기차시심폐복소술후(18.5％).cVEEG현시,49례(90.7％)수차배경이상,19례(35.2％)가견전간방전,8례(14.8％)진단위비량궐성전간지속상태(NCSE);재6례인추휵의사전간적환자중,부1례동기cVEEG현시전간방전;표현위전정식、엄범성저전압、폭발-억제、미만성θ파배경、지속성미만성전간방전、주기파자병사솔고.결론 뇌혈관의외시본조의식장애환자적주요원인,cVEEG유리우림상진단여감별진단급환자예후평고.
Objective To evaluate the application value of continuous videoelectroencephalographic (cVEEG) monitoring in patients with consciousness disorders in intensive care unit (ICU).Methods Retrospective analyses were conducted for applying cVEEG in the clinical diagnosis and outcome evaluation of 54 patients with consciousness disorders in intensive care unit (ICU) at our hospital from January 2008 to April 2014.Results The most common cause was cerebrovascular disease (46.3％) followed by ischemic-hypoxic encephalopathy after cadio-pulmonary resuscitation (18.5％).And 49 cases (90.7％) showed an abnormal background on initial cVEEG,19 cases (35.2％) had epileptic discharge and 8 cases (14.8％) were diagnosed with nonconvulsive status epilepticus (NCSE).Among 6 cases of convulsive patients,only 1 had epileptic discharge patterns of isoelectric,invariable low amplitude.Burstsuppression,persistent θ rhythm-like background activity,persistent diffuse epileptic discharge and periodic waves had high mortality rate.Conclusion Stroke is a major cause of consciousness disorders.And continuous VEEG monitoring is beneficial for clinical diagnosis,differential diagnosis and outcome evaluation.