首页|基于定量脑电图及经颅多普勒的多模脑功能监测评估急性高血压性脑出血血肿扩大及预后的价值

基于定量脑电图及经颅多普勒的多模脑功能监测评估急性高血压性脑出血血肿扩大及预后的价值

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目的 评估定量脑电图(QEEG)和经颅多普勒(TCD)的多模脑功能监测在预测急性高血压性脑出血患者血肿扩大及预后的价值.方法 回顾性分析2019年10月至2022年10月120例急性高血压性脑出血患者的临床资料.所有患者在入院24 h内接受QEEG和TCD检查,并根据血肿是否扩大将患者分为血肿扩大组(79例)和血肿稳定组(41例).通过对比两组间QEEG和TCD的参数差异,探究这些监测指标与血肿扩大及患者预后之间的关联.结果 血肿扩大组的患者年龄较高,且吸烟比例也较高,血肿扩大组患者的初始神经功能损伤更严重,血肿扩大组在脑出血后不同时间点的DAR和DTABR值均高于续血肿稳定组(P<0.05).相关性分析显示DAR、DTABR和P1与血肿扩大呈正相关,其中DAR和DTABR的相关性尤其强(r值分别为 0.774 和 0.738,P<0.05),P1 的相关性相对较弱(r=0.213,P<0.05).ROC曲线分析显示DAR、DTABR和P1参数在预测血肿扩大方面具有高灵敏度和特异度,DAR的AUC值高达0.970.随访期间,血肿稳定组的MRS评分在所有时间点上优于血肿扩大组(P<0.05).结论 QEEG和TCD有助于早期识别高风险患者,从而实施更有针对性的治疗措施,改善患者的临床结果.
The value of multimodal brain function monitoring based on QEEG and TCD in evaluating hematoma enlargement and prognosis in acute hypertensive intracerebral hemorrhage
Objective To evaluate the value of multimodal brain function monitoring using quantitative electroencephalography(QEEG)and transcranial Doppler(TCD)in predicting hematoma enlargement and prognosis in patients with acute hypertensive intracerebral hemorrhage.Methods A retrospective analysis was conducted on the clinical data of 120 patients with acute hypertensive intracerebral hemorrhage from October 2019 to October 2022.All patients underwent QEEG and TCD examinations within 24 hours of admission,and were divided into hematoma enlargement group(79 cases)and hematoma stabilization group(41 cases)based on whether the hema-toma had expanded.By comparing the parameter differences of QEEG and TCD between two groups,explore the correlation between these monitoring indicators and hematoma enlargement and patient prognosis.Results The patients in the hematoma enlargement group had a higher average age and a higher smoking rate.The initial neuro-logical damage in the hematoma enlargement group was more severe.The DAR and DTABR values of the hematoma enlargement group were significantly higher than those of the stable group at different time points after cerebral hemorrhage(P<0.05).Correlation analysis shows that DAR,DTABR,and P1 have significant positive correla-tions with hematoma enlargement,with DAR and DTABR showing particularly strong correlations(r values of 0.774 and 0.738,respectively,P<0.05),while P1 has relatively weak correlations(r=0.213,P<0.05).ROC curve analysis shows that DAR,DTABR,and P1 parameters have high sensitivity and specificity in predicting hematoma enlargement,with an AUC value of up to 0.970 for DAR.During the follow-up period,the MRS scores of the stable hematoma group were significantly better than those of the hematoma expansion group at all time points(P<0.05).Conclusion QEEG and TCD are helpful in early identification of high-risk patients,enabling more targeted treatment measures and improving clinical outcomes for patients.

acute hypertensive intracerebral hemorrhagehematoma enlargementquantitative elec-troencephalogramtranscranial Dopplerprognosis

孙实安、王迎东、程晓峰、邸燕娜、姜健慧、于朝旭

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承德市中心医院神经外科(河北 承德 067000)

承德市中心医院颈脑血管超声室(河北 承德 067000)

急性高血压性脑出血 血肿扩大 定量脑电图 经颅多普勒 预后

2025

实用医学杂志
广东省医学情报研究所

实用医学杂志

北大核心
影响因子:1.549
ISSN:1006-5725
年,卷(期):2025.41(1)