| Objectives To investigate the quantitative index in patients with neurological intensive 14 d in the dynamic change process;to investigate the value of EEG grade,QEEG,SEP grade,BAEP grade and combined index in evaluating the condition and prognosis of patients,so as to provide a theoretical basis for timely assessment of brain function changes,guide treatment and predict prognosis.Methods 1 Selection of patients with neurological intensive and consciousness disorder in NICU of Kailuan General Hospital from August 2016 to December 2017,recording the onset or exacerbations of 3d in patients with NIHSS,APACHE II,and GCS for patients with severity evaluation.2 The patients respectively in the onset or exacerbations in 3d,7d and 14 d were monitored by EEG,recording the quantitative indicators such as BSI,the two sides hemisphere alpha wave index,slow wave index and delta,beta,theta wave absolute power,explore the quantitative index 14 d in the dynamic evolution process,in order to reveal the changes of patients with neurological intensive,and analyze the value of quantitative indicators to determine the condition and prognosis of patients.3 In the onset or exacerbations of 3d the EEG Synek grade and Young grade;and cerebral evoked potentials,Judson grade and Hall grade were recorded;and the combination index of EEG grade and brain evoked potential grade,evaluating the condition and prognosis of patients.4 The patients were followed up and in 3 months,recording the GOS to expor the effect of brain electrical physiological indexes on the prognosis of the patients.Results 1 In the onset or exacerbations of 3d in EEG,SEP and BAEP were detected in 61 cases,including 26 patients with massive cerebral infarction,27 patients with cerebral hemorrhage,8 patients with the bilateral hemispheric lesions;in 34 cases of the patients were three different time points for the detection,including 12 cases of cerebral hemorrhage patients,14 cases of cerebral infarction,and 8 cases of bilateral hemisphere lesions;according to the GOS,34 cases with good prognosis and 27 cases with poor prognosis.2 The continuous detection of in patients with cerebral hemorrhage,3d BSI was higher than that of 7d and 14 d,7d and14 d of the slow wave index of uninjured side is higher than that of 3d,7d of the uninjured side delta is higher than 3d,7d and 14 d of the uninjured side theta is higher than that 3d(P<0.05);patients in14 d the uninjured side of alpha index is higher than contralateral side,3d the affected side of slow wave index and delta,theta was higher than that the uninjured side(P<0.05).3 The continuous detection of patients with cerebral infarction,7d BSI is higher than 3d and 14 d,and 3d of the affected side of theta is higher than that of 7d and 14d(P<0.05);patients in 7d and14 d of the affected side of alpha index,slow wave index and theta were lower than contralateral side,7d the affected side of delta was lower than that of the uninjured side,(P<0.05).4 there was no difference in two sides of patients in bilateral cerebral hemisphere lesions(P>0.05).5 The Synek,Young,bilateral slow wave index,bilateral delta,healthy side theta,combined index were negatively correlated with GCS;Synek,the healthy side slow wave index,the bilateral of delta,healthy side theta,Judson,combined index was positively correlated with NIHSS;Synek,combined index was positively correlated with APACHE(P<0.05).6 The single factor analysis showed that GCS,APACHE II,NIHSS,BSI,the bilateral slow wave index,the affected side of theta,Synek and combined index had the difference between the prognosis.The multivariate analysis showed that combined index,NIHSS and BSI had an impact on prognosis(P<0.05).The area under the curve of the ROC was 0.76±0.07,0.87±0.04,0.72±0.07,and the sensitivity to prognosis is 63%,89%,67%,The specificity is 88%,71%,71%,The accuracy is 61%?79%?69%.Conclusions 1 In patients with unilateral cerebral hemisphere cerebral hemorrhage and large area cerebral infarction in unilateral cerebral hemisphere,the QEEG index within 14 days of onset or aggravation has its characteristics,which can reflect the change of the patient's condition to a certain extent,and the EEG slow wave activity is a major factor contributing to the power of bilateral cerebral hemisphere and symmetry changes.2 The QEEG,EEG grade,combined index are related with early clinical scores and prognosis,has a certain advantage in evaluating the severity and prognosis of the patients with severe neurotic disease,and combined index can reduce the limitation of single and improve specificity evaluating patient's prognosis. |
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