Application of Electroencephalogram, Short Latency Somatosensory Evoked Potential and Transcranial Doppler Ultrasound in the Determination of Brain Death
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摘要:
目的 探究脑电图、短潜伏期体感诱发电位和经颅多普勒超声在脑死亡判定中的价值和应用。 方法 收集昆明市第一人民医院经临床判定为脑死亡的患者31例，对每位患者均进行2次脑电图、短潜伏期体感诱发电位和经颅多普勒超声检测，根据脑死亡确认实验标准将其分为脑死亡阳性组和脑死亡阴性组，比较3种检查方式的敏感性、特异性和准确性。 结果 脑电图的敏感性、特异性和准确性均高于短潜伏期体感诱发电位和经颅多普勒超声检测，其敏感性为100%、特异性为75%和准确性为93.55%。脑死亡组脑电图和短潜伏期体感诱发电位阳性人数显著高于非脑死亡组，差异有统计学意义（P < 0.05）。 结论 ROC曲线分析显示脑电图对诊断脑死亡效果佳。 -
关键词:
- 脑死亡 /
- 脑电图 /
- 短潜伏期体感诱发电位 /
- 经颅多普勒超声
Abstract:Objective To explore the value and application of electroencephalogram, short latency somatosensory evoked potential and transcranial Doppler ultrasound in the determination of brain death. Methods 31 patients with brain death in our hospital were enrolled. Each patient was tested twice by electroencephalogram, short latency somatosensory evoked potential and transcranial Doppler ultrasound. According to the experimental standard of brain death confirmation, they were divided into brain death positive group and brain death negative group. The sensitivity, specificity and accuracy of the three tests were compared. Results The sensitivity, specificity and accuracy of EEG were higher than those of short latency somatosensory evoked potentials and transcranial Doppler, with sensitivity of 100%, specificity of 75% and accuracy of 93.55%. The number of positive EEG and short latency somatosensory evoked potential in brain death group was significantly higher than that in non-brain death group, the difference was statistically significant （P < 0.05）. Conclusion ROC curve analysis showed that electroencephalogram was effective in diagnosing brain death. -
表 1 3种检测方法对脑死亡的诊断价值比较（%）
Table 1. Comparison of the diagnostic value of three testing methods for brain death （%）
项目 敏感性 特异性 准确性 EEG 100.00 75.00 93.55 SLSEP 95.65 50.00 83.87 TCD 86.96 12.50 67.74 
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表 2 3种检测结果的比较[n（%）]
Table 2. Comparison of the results of the three tests [n（%）]
检查方式 脑死亡阳性组（n = 23） 脑死亡阴性组（n = 8） 合计 χ2 P EEG 21.390 < 0.001* 阳性 23（100） 2（25） 25 阴性 0（0） 6（75） 6 SLSPE 9.144 0.002* 阳性 22（95.65） 4（50） 26 阴性 1（4.35） 4（50） 5 TCD 0.002 0.968 阳性 20（86.96） 7（87.5） 27 阴性 3（13.04） 1（12.5） 4 *P < 0.05。
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