标题：脑干听觉诱发电位分级对脑创伤长期意识障碍患者预后评估的价值

      作者：周月玲 1，谢成金 2，王向宇 2
    (南方医科大学珠江医院神经内科脑电图室 1、神经外科 2，广东 广州 510282)

      卷次： 2014年25卷1期

      【摘要】 目的 通过对脑干听觉诱发电位(BAEP)的检测，探讨BAEP分级对长期昏迷脑损伤患者预后评估
的临床价值。方法 根据93例脑损伤后意识障碍超过2周的患者清醒前BAEP检测结果，将BAEP分为Ⅰ级、Ⅱ
级和Ⅲ级。采用格拉斯哥预后评分(GOS)作为判断标准对患者的预后进行评估，并进一步分析BAEP分级与预
后评估之间的关系。结果 Ⅰ级的预后不良率为36.48%，Ⅱ级和Ⅲ级的总预后不良率为94.55%。分级与预后
差异有统计学意义(P＜0.05)，分级越高，患者预后越差。结论 BAEP能客观敏感地反映中枢神经系统功能，因
而BAEP分级科学地反映了不同程度的脑功能损伤，进而准确预测预后情况，具有较好的临床应用价值。

      【关键词】 脑干听觉诱发电位；颅脑损伤；意识障碍；预后

      【中图分类号】 R651.1 【文献标识码】 A 【文章编号】 1003—6350（2014）01—0029—03


Clinical value of brainstem auditory evoked potential grading to the evaluation of the prognosis in long-term
coma patients after traumatic brain injury.
ZHOU Yue-ling 1, XIE Cheng-jin 2, WANG Xiang-yu 2.1. EEG Center of
Neurology, 2. Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282,
Guangdong , CHINA

【Abstract】 Objective To explore the clinical value of evaluation in prediction of the prognosis in
long-term coma patients after severe traumatic brain injury through brainstem auditory evoked BAEP grading.
Methods BAEPs were recorded and analyzed in 93 patients suffered from TBI with duration of disturbance of un-
consciousness. BEAPs were classified into three grades：GradeⅠ- all BEAPs were normal; GradeⅢ- bilateral PL of
wave V or IPL of wave Ⅲ~Ⅴwere abnormal，unilateral or bilateral wave Ⅴ were absent: GradeⅡ-any abnormal
BAEPs except GradeⅢ, including unilateral or bilateral peak latency (PL) of waveⅠandⅢ, inter peak latency (IPL)
of waveⅠ~Ⅲ or amplitude ratio of waveⅠandⅤ were abnormal，or unilateral PL of waveⅤ or IPL of waveⅢ~Ⅴ
were abnormal. GOS was regarded as a criterion to assess the prognosis of patients to further analyze the relationship
between BAEP grading and the prognosis. Results Poor prognosis rate was 36.84% in gradeⅠ. The total poor prog-
nosis rate was 94.55% in gradeⅡ and Ⅲ. The difference of grades and prognosis was statistically significant (P <
0.05), and the higher grade accompanies, the more poor prognosis of patients. Conclusion BAEP can reflect the cen-
tral nervous system function objectively and sensitively, and the BAEP grading can demonstrate brain dysfunction and
predict patients' prognosis accurately with better clinical value.