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1、484中国脑血管病杂志2006年11月18日第3卷第11期ChinJCerebrovascDis,Nov.18,2006,Vol.3,No.11临床研究心肺复苏后昏迷患者脑电图模式对预后的预测宿英英李红亮【摘要】目的探讨心肺复苏后昏迷患者脑电图评估时间和脑电图模式对预后预测的价值。方法选择64例心肺复苏后昏迷患者行脑电图评估。按首次脑电图监测时间段将患者分为1～3d、4～7d及>7d监测组。脑电图监测包括全面抑制、爆发-抑制、α/θ昏迷和慢波增多四个模式,临床预后(格拉斯哥预后评分)以6个月为终点。分别统计四个脑电图模式在三个时间段内预测预后的敏
2、感性、特异性、阳性预测值、假阳性率及总符合率。结果心肺复苏后脑电图全面抑制模式在7d内预测预后不良敏感性(67%～80%)、特异性(100%)较高;爆发-抑制模式在7d内预测预后不良特异性高(100%),但敏感性(6%～8%)低;α/θ昏迷模式预测预后不良敏感性为3%～40%、特异性为50%～67%;慢波增多在7d内预测预后良好敏感性(100%)、特异性(91%～94%)均高。结论心肺复苏后早期(7d内)脑电图显示全面抑制和爆发-抑制模式预测预后不良准确、可靠;慢波增多模式预测预后良好准确、可靠;α/θ昏迷模式预测预后不良的准确性和可靠性有限。【
3、关键词】心肺复苏术;昏迷;脑电描记术;Glasgow预后评价【中图分类号】R741.044【文献标识码】AElectroencephalographicpatternsandpredictionofoutcomeincomatosesurvivorsaftercardiopul-monaryresuscitationSUYing-ying,LIHong-liang.Neuro-IntensiveCareUnit,DepartmentofNeurology,XuanwuHospital,theCapitalUniversityofMedicalSc
4、iences,Beijing100053,ChinaAbstract:ObjectiveToexploretheopportunityofelectroencephalographic(EEG)evaluationandtheprognosticvalueoftheEEGpatternsincomatosesurvivorsaftercardiopulmonaryresuscitation(CPR).MethodsSixty-fourcomatosesurvivorswereselectedforEEGevaluationafterCPR.Acc
5、ord-ingtothetimeintervalsofthefirstEEGmonitoring,thepatientsweredividedinto1-3day,4-7day,and>7daygroups.TheEEGmonitoringincludedgeneralizedsuppression,burst-suppression,alphaorthetacoma,andslowwaveincreasepatterns.Theendpointofclinicaloutcome(GlasgowOutcomeScalescore)wasevalu
6、atedat6months.The4typesofEEGpatternswerecalculatedrespectively,andtheprognosticsensitivity,specificity,positivepredictivevalue,falsepositiverates,andtotalconsistentratesduringthe3timeintervalswerepredicted.ResultsThegeneralizedsuppressionpatternhadahighersensitivity(67%～80%)a
7、ndspecificity(100%)inpredictingunfavorableprognosiswithin7daysafterCPR;theburstsuppressionpatternhadahigherspecificity(100%)inpredictingunfavorableprognosiswithin7days,however,itssensitivitywaslow(6%～8%);Theslowwaveincreasepatternhadhighsensitivity(100%)andspecificity(91%～94%
8、)inpredictingfavorableprognosiswithin7days;andthesensitivitywas3%～40
