發(fā)布時間：2018-07-27 10:53

【摘要】：研究目的:腦卒中是成人致死致殘的主要原因之一。本文研究目的在于探討定量腦電圖對重癥腦梗死患者預(yù)后的預(yù)測價(jià)值,并探索最佳預(yù)測指標(biāo)。研究方法:對收入神經(jīng)內(nèi)科重癥監(jiān)護(hù)室的22名首次發(fā)病的幕上腦梗死患者,在發(fā)病24-72h進(jìn)行腦電圖監(jiān)測。同時對其進(jìn)行美國國立衛(wèi)生院卒中量表(The National Institutes of Health Stroke Scale,NIHSS)評分以及頭部梗死范圍評估。發(fā)病6個月后進(jìn)行電話隨訪,用m RS(modified Rankin Scale)評估患者預(yù)后。選擇具有代表性原始EEG片段進(jìn)行定量分析。將定量腦電圖頻譜指標(biāo)與患者6個月預(yù)后進(jìn)行相關(guān)性分析。根據(jù)預(yù)后比較患者定量腦電圖頻譜指標(biāo),并進(jìn)行受試者工作特征曲線(receiver operating characteristic curve,ROC曲線)分析。研究結(jié)果:1、相對δ功率、(δ波功率+θ波功率)/(α波功率+β波功率)、(δ波功率/α波功率)、NIHSS評分、梗死面積與患者6月的m RS呈正相關(guān)。相對θ功率、相對α功率與患者6月的m RS呈負(fù)相關(guān)。2、死亡組患者與存活組患者在梗死面積、NIHSS評分、相對δ功率、相對α功率、相對θ功率、DAR以及DTABR等方面均有統(tǒng)計(jì)學(xué)差異。在QEEG指標(biāo)中,相對δ功率能有效區(qū)分死亡組和非死亡組,準(zhǔn)確率高達(dá)86.36%。3、中度殘疾與重度殘疾在年齡、相對δ功率、相對θ功率以及(δ波功率/α波功率)等方面存在統(tǒng)計(jì)學(xué)差異。其中相對θ功率能有效分辨中度殘疾和重度殘疾組,準(zhǔn)確率92.86%。研究結(jié)論:定量腦電圖對重癥監(jiān)護(hù)室腦梗死患者6月的預(yù)后具有明顯的提示作用。
[Abstract]:Objective: stroke is one of the main causes of death and disability in adults. The purpose of this study was to explore the prognostic value of quantitative electroencephalogram (QEEG) in patients with severe cerebral infarction and to explore the best predictor. Methods: electroencephalogram (EEG) monitoring was performed in 22 patients with supratentorial cerebral infarction who were admitted to the neurology intensive care unit for 24-72 hours. The National Institutes of Health (NIH) Stroke scale (The National Institutes of Health Stroke scale NIHSS) and head infarct size were also evaluated. Patients were followed up by telephone 6 months after onset and m RS (modified Rankin Scale) was used to evaluate the prognosis. The representative original EEG fragments were selected for quantitative analysis. The correlation between quantitative electroencephalogram (QEEG) spectrum index and 6 months prognosis was analyzed. The quantitative electroencephalogram (EEG) spectral indices were compared according to the prognosis, and the operating characteristic curve (receiver operating characteristic curveROC curve) was analyzed. The results showed that there was a positive correlation between infarct size and MRs of patients in 6 months. The results were as follows: 1: 1, relative 未 power, (未 wave power 胃 wave power) / (偽 wave power, 尾 wave power,), (未 wave power / 偽 wave power) had a positive correlation with the infarct size. Relative 胃 power and relative 偽 power were negatively correlated with Mrs in 6 months. There were significant differences in infarct area, relative 未 power, relative 偽 power, relative 胃 power and DTABR between patients with death and those with survival. In QEEG, relative 未 power can effectively distinguish the death group from the non-dead group, and the accuracy is as high as 86.36. 3. There are statistical differences in age, relative 未 power, relative 胃 power and (未 wave power / 偽 wave power) between moderate disability and severe disability. The relative 胃 power can effectively distinguish moderate and severe disability groups, and the accuracy rate is 92.86. Conclusion: quantitative electroencephalogram (QEEG) has a significant effect on the prognosis of patients with cerebral infarction in intensive care unit (ICU) for 6 months.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.33

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