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目的:探讨体感诱发电位参数N20评价意识障碍患者预后的价值。方法:回顾性分析110例因各种因素(外伤、心肺复苏术后、缺血缺氧、脑血管病等)导致意识障碍患者的病史、病程和体感诱发电位N20的数据;并进行1年的随访,观察患者预后转归。采用描述性分析,独立样本t检验、ROC曲线及Kaplan-Meier分析等方法进行统计学分析。结果:110例意识障碍患者随访中死亡2例予以剔除,共纳入分析病例108例。根据意识恢复情况分为:意识恢复组(52例);意识未恢复组(56例)。N20潜伏期判断患者预后有着较好的评判价值(ROC曲线下面积分别为C3-’N20:77.6%,C4-’N20:79.3%),意识恢复组双侧N20潜伏期均较意识未恢复组短,但两组患者的波幅差异均无统计学意义。C4-’N20潜伏期界定为20.05 ms时及C3-’N20潜伏期界定为19.95 ms时有着较好的敏感度和特异度(C4-’N20:70.8%,75.0%,C3-’N20:75.0%,72.0%);Kaplan-Meier分析结果显示C3-’N20潜伏期<19.95 ms及C4-’N20潜伏期<20.05 ms的患者1年内能够恢复的概率最大,恢复时间最短。结论:体感诱发电位N20潜伏期能够较好评价意识障碍患者预后,其中以C4-’N20潜伏期20.05 ms及C3-’N20潜伏期19.95 ms为较好的界定值。
Objective: To investigate the value of somatosensory evoked potential parameter N20 in evaluating the prognosis of patients with impaired consciousness. Methods: A retrospective analysis of 110 cases of patients with disturbance of consciousness due to various factors (trauma, cardiopulmonary resuscitation, hypoxia, cerebrovascular disease) in patients with history, duration and somatosensory evoked potential N20 data; and 1 year Follow-up, observation of prognosis of patients. Descriptive analysis, independent sample t test, ROC curve and Kaplan-Meier analysis were used for statistical analysis. Results: 110 cases of impaired consciousness were followed up and 2 cases were rejected. A total of 108 cases were included in the analysis. According to the recovery of consciousness, it is divided into consciousness recovery group (52 cases) and unconsciousness recovery group (56 cases). The N20 incubation period had a better prognostic value (area under the ROC curve was C3-’N20: 77.6%, C4-’N20: 79.3%, respectively). Both N20 incubation periods in conscious recovery group were shorter than those in unconscious recovery group, However, there was no significant difference in amplitude between the two groups. The C4-N20 latency was defined as 20.05 ms and the C3-N20 latency was defined as 19.95 ms with good sensitivity and specificity (C4-N20: 70.8%, 75.0%, C3-N20: 75.0% 72.0%). Kaplan-Meier analysis showed that patients with C3-’N20 latency <19.95 ms and C4-’N20 latency <20.05 ms had the highest probability of recovery within one year and the shortest recovery time. CONCLUSIONS: The somatosensory evoked potentials N20 latency can be used to evaluate the prognosis of patients with impaired consciousness. Among them, C4-’N20 latency is 20.05 ms and C3-N20 latency is 19.95 ms.