Discussion On The Prognosis Evaluation Value Of Multiple Nerve Electrophysiology Methods Combination On Patients With Disturbance Of Consciousness

Objective 1.The potential influential factors of brain function recovery of patients with different degrees' disturbance of consciousness are analyzed.2.The relation between nerve electrophysiology examination(including EEG and EP)and brain function recovery of patients with disturbance of consciousness is discussed.3.GCS,EEG,SEP and BAEP are utilized to conduct prognosis evaluation toward patients with disturbance of consciousness.Methods 1.44 patients with different degrees disturbance of consciousness(GCS 3-14)(March 2016-January 2017)of Fujian Medical University Union Hospital whose neurology,NCU and ICU confirm to incorporating and exclusion standards are collected.Their age,gender,brain injury categories and other clinical documents are recorded,and nerve electrophysiology examination,including EEG by bedside,SLSEP,and BAEP examinations,is conducted.2-month follow up visits are conducted to all patients.Glasgow prognosis scale is employed to evaluate prognosis,and the patients are divided into arousal(3-5 points GOS)and un-arousal(1-2 points)groups,and arousal group is favorable prognosis group and un-arousal group is unfavorable prognosis group.2.EEG monitoring in nerve electrophysiology examination employs Synek EEG classification to divide patients into 5 levels.SLSEP results judge them as normal bilateral N20 wave and morbid N20 wave.BAEP judges them as normal bilateral V wave and morbid V wave.Nerve electrophysiology examination is combined to analyze prognosis relation,and statistical software--SPSS 18.0 is employed to conduct correlation analysis toward the examination results and patients prognosis.If P<0.05,the difference has statistical significance.Results 1.2-month follow-up visits are conducted toward the 44 patients with disturbance of consciousness after examination,among which 13 patients are death(29.54%),9 patients are in persistent coma(20.45%),and 22 patients recover consciousness(50%).Dead patients and patients in persistent coma are regarded as un-arousal(GOS 1-2).The age and gender differences of patients have no statistical significance(P>0.05).2.Synek classification is conducted toward the EEG monitoring and prognosis relation of all patients' EEG monitoring results,among which 12 patients in 1 level,10 patients in 2 level,7 patients in 3 level,14 patients in 4 level,and 1 patient in 5 level.In Synek favorable prognosis group(Synek 1 and 2 levels),there are 3 patients dead(3/22),1 patient in persistent coma(1/22),18 patients recovering consciousness(18/22).While in unfavorable prognosis group(Synek 3-5 levels),there are 10 patients dead(10/22),22 patients in persistent coma(8/22),and 4 patients recovering consciousness(4/22).The X2 examination prompts that P<0.05 and the difference has statistical significance.3.In the 13 dead patients of SLSEP and prognosis relation,there are 10 patients whose bilateral N20 wave disappear(10/13),and 1 patient with N20 appearance(1/13),2 with bilateral N20 appearance(2/13).In the 9 patients in persistent coma,there are 6 patients whose bilateral N20 wave disappear(6/9),and 2 patients with hemi N20 appearance(2/9),1 patient with bilateral N20 appearance.In the 10 patients recovering consciousness,there are 1 patient whose bilateral N20 wave disappear(1/22),and 11 patients with hemi N20 wave appearance(11/22),10 patients with bilateral N20 wave appearance(10/22).The X2 examination prompts that P<0.05 and the difference has statistical significance.4.In the 13 dead patients of BAEP and prognosis relation,there are 7 patients whose bilateral V wave disappear(7/13),and 3 patients with hemi V wave appearance(3/13),3 patients with bilateral V wave appearance(3/13).In the 9 patients in persistent coma,there are 3 patients whose bilateral V wave disappear(3/9),and 3 patients with hemi V wave appearance(3/9),3 patients with bilateral V wave appearance(3/9).In the 22 patients recovering consciousness,there are 2 patients whose bilateral V wave disappear(2/22),and 4 patients with hemi V wave appearance(4/22),and 16 patients with bilateral V wave appearance(16/22).The X2 examination prompts that P<0.05 and the difference has statistical significance.Conclusion Nerve electrophysiology examination EEG,SLSEP,and BAEP can provide an effective predication technique for the prognosis of patients in coma in clinical practice.The combination evaluation not only can judge the brain injury degree of patients in coma,but also can provide reference for the arousal possibility of patients in coma.