中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (10): 948-954.doi: 10.3969/j.issn.1673-5374.2013.10.010

• 原著:神经损伤修复保护与再生 • 上一篇    下一篇

体感诱发电位评估长期昏迷弥漫性轴索损伤患者的预后及苏醒率

  

  • 收稿日期:2012-06-18 修回日期:2012-11-30 出版日期:2013-04-05 发布日期:2013-04-05

Prognosis in prolonged coma patients with diffuse axonal injury assessed by somatosensory evoked potential

Xiujue Zheng1, Mantao Chen1, Jingqi Li2, Fei Cao1   

  1. 1 Department of Neurosurgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
    2 Hangzhou Hospital of Zhejiang Armed Police Corps, Hangzhou 310018, Zhejiang Province, China
  • Received:2012-06-18 Revised:2012-11-30 Online:2013-04-05 Published:2013-04-05
  • Contact: Fei Cao, M.D., Professor, Department of Neurosurgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China, cfneuron@ yahoo.com.cn.
  • About author:Xiujue Zheng☆, M.D., Professor.

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摘要：

收集浙江大学医学院第一附属医院因脑损伤入院诊断为弥漫性轴索损伤患者43例，脑损伤1个月后进行体感诱发电位检测，以N20波幅和中枢传导时间将患者分为预测诱发电位I-Ⅲ级，分别代表皮质N20正常、异常及缺失患者。诱发电位预测为Ⅲ级的患者，平均Glasgow预后分级较低；体感诱发电位Ⅲ级的患者，伤后6个月预后预测准确率为100％，未苏醒的精度为80%；而预测为I级的患者预测准确率为86％，未苏醒精度为100％。表明体感诱发电位的等级与昏迷的严重及恢复程度呈良好的相关性，体感诱发电位可对长期昏迷的弥漫性轴索损伤患者有良好的预后评估价值。

关键词: 神经再生, 脑损伤, 体感诱发电位, 弥漫性轴索损伤, N20, 昏迷, 预后, 苏醒, 脑损伤, 神经电生理, 基金资助文章

Abstract:

A total of 43 prolonged coma patients with diffuse axonal injury received the somatosensory evoked potential examination one month after injury in the First Affiliated Hospital, School of Medicine, Zhejiang University in China. Somatosensory evoked potentials were graded as normal, abnormal or absent (grades I–III) according to N20 amplitude and central conduction time. The outcome in patients with grade III somatosensory evoked potential was in each case unfavorable. The prognostic accuracy of grade III somatosensory evoked potential for unfavorable and non-awakening outcome was 100% and 80%, respectively. The prognostic accuracy of grade I somatosensory evoked potential for favorable and wakening outcome was 86% and 100%, respectively. These results suggest that somatosensory evoked potential grade is closely correlated with coma severity and degree of recovery. Somatosensory evoked potential is a valuable diagnostic tool to assess prognosis in prolonged coma patients with diffuse axonal injury.

Key words: neural regeneration, brain injury, somatosensory evoked potential, diffuse axonal injury, coma, prognosis, awakening, nerve electrophysiology, grants-supported paper, neuroregeneration