本文選題：振幅整合腦電圖 + 急性生理-慢性健康狀態(tài)評分�。� 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：應(yīng)用aEEG對神經(jīng)內(nèi)科監(jiān)護(hù)室意識障礙患者進(jìn)行腦電監(jiān)護(hù)，探討aEEG對意識障礙患者近期預(yù)后的預(yù)測價值，同時行APACHE II、GCS評分，比較三種評估方法的優(yōu)劣。對象與方法：本研究持續(xù)2+年時間（2011年12月~2014年2月），共收集91例我院神經(jīng)內(nèi)科重癥監(jiān)護(hù)病房收治的意識障礙患者。符合納入標(biāo)準(zhǔn)78例，其中男性45例，女性33例，年齡18-83歲，平均年齡60.77±18.64。aEEG監(jiān)護(hù)時間至少30min，同時在24小時內(nèi)行APCHE II評分及GCS評分。應(yīng)用Hosmer Lemeshow擬合優(yōu)度檢驗(yàn)評價其預(yù)測校準(zhǔn)度，受試者工作特征曲線來評價三種評估方法的預(yù)測鑒別度。結(jié)果：實(shí)際死亡26例（33.3%），三種評估方法在全組水平的預(yù)測校準(zhǔn)度均較佳。aEEG評分預(yù)測全組死亡16例[95％CI(9，26)]，APACHE預(yù)測死亡31例[95％CI(26，35)]，GCS判斷死亡例數(shù)24例[95％CI(16，，32)]。分組校準(zhǔn)度中aEEG及APCHE II預(yù)測校準(zhǔn)度良好（aEEG,χ2=0，P=1,d.f.=1；APACHE, χ2=8.041，P=0.429,d.f.=8）,GCS評分預(yù)測校準(zhǔn)度不佳（χ2=18.687，P=0.005，d.f.=6）。三種評估方法的預(yù)測鑒別度均良好，ROC曲線下面積＞0.7（aEEG0.781，APACHE II0.757，GCS0.768）。曲線下面積的差異無統(tǒng)計(jì)學(xué)意義。結(jié)論：aEEG對意識障礙患者近期預(yù)后有良好的預(yù)判能力。與傳統(tǒng)APACHE II評分及GCS評分比較其預(yù)測校準(zhǔn)度較好，鑒別能力沒有差異。
[Abstract]:Objective: to evaluate the value of aEEG in predicting the short term prognosis of patients with consciousness disorder in neurology intensive care unit (NICU) by EEG monitoring, and to compare the advantages and disadvantages of the three evaluation methods. Participants and methods: the study lasted for 2 years (December 2011 to February 2014). 91 patients with consciousness disorders were admitted to intensive care unit (ICU) of neurology department in our hospital. 78 cases met the inclusion criteria, including 45 males and 33 females, aged 18-83 years, with an average age of 60.77 鹵18.64.aEEG monitoring time of at least 30 minutes, and APCHE II score and GCS score within 24 hours. The predictive calibration degree was evaluated by Hosmer's Lemeshow goodness of fit test and the predictive discriminant degree of the three evaluation methods was evaluated by the operating characteristic curve of the subjects. Results: in 26 cases of actual death, the accuracy of prediction and calibration of the three evaluation methods were all better. AEEG score predicted 16 cases of death in the whole group [95CII 926] Apache predicted 31 cases of death [95CII 26 / 35] GCS estimated the number of death cases in 24 cases [95CI1632]. The predicted calibration degree of aEEG and APCHE II in grouping calibration degree was good. The calibration degree of aEEG and APCHE II was not good (蠂 ~ 2 ~ 2 ~ (18. 68) P 0.005 d.f. ~ (6), 蠂 ~ (2 +) ~ (8.041) / P ~ (0.429) d.f. ~ (8) ~ (1) ~ (1). The area under the ROC curve of the three evaluation methods was better than 0.7aEEG0.7781Ach II0.757G CS0.768. There was no significant difference in area under the curve. Conclusion: EEG has a good ability to predict the short-term prognosis of patients with disturbance of consciousness. Compared with the traditional APACHE II score and GCS score, its predictive calibration degree is better, and there is no difference in discriminant ability.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R742.1

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