脑电图联合脑CT灌注成像评价蛛网膜下腔出血预后的临床研究(1)
摘要：目的 探讨脑电图联合脑CT灌注成像对蛛网膜下腔出血(SAH)预后的影响。方法 选取2015年12月～2016年12月收入医院的SAH患者共30例作为研究对象，将其平均分为两组，对照组和实验组。实验组在脑CT灌注成像时联合应用脑电图(EEG)对SAH患者进行检测，对照组应用脑CT灌注成像。观察并记录MTT、TTP、CBF、CBV、痫样发作例数和脑血管痉挛(CVS)例数。结果 CVS组MTT和TTP均高于nCVS组，CBF和CBV组均低于nCVS组，差异有统计学意义(P<0.05)。实验组痫样发作例数和脑血管痉挛例数均高于对照组，差异有统计学意义(P<0.05)。结论 脑电图联合脑CT灌注成像对蛛网膜下腔出血(SAH)预后具有积极的作用。
关键词： CTP；脑电图；蛛网膜下腔出血
中图分类号：R743.35 文献标识码：A 文章编号：1006-1959(2017)16-0041-03
, 百拇医药 Clinical Evaluation of Electroencephalogram Combined with Brain CT Perfusion Imaging in the Prognosis of Subarachnoid Hemorrhage
WANG Qi-min，WANG Ye-zhong，LIU Qi，JI Yun-xiang，DAI Lin-zhi，DONG Jiang-tao，ZHAO Dong
(Department of Neurosurgery，First Affiliated Hospital of Medical College of Shihezi University，Shihezi 832000，Xinjiang，China)
Abstract：Objective To investigate the EEG combined cerebral CT perfusion imaging on subarachnoid hemorrhage(SAH)prognosis.Methods From December 2015 to December 2016 the hospital income of 30 cases of SAH patients as the research object，will be divided into two groups，control group and experimental group.In the experimental group，SAH was detected by electroencephalogram(EEG)in brain CT perfusion imaging，and brain CT perfusion imaging was used in the control group.Observe and record the MTT，TTP，CBF，CBV，the number of cases of epileptic seizures and cerebral vasospasm(CVS)cases.Results In group CVS，MTT and TTP were higher than nCVS group，CBF group and CBV group were lower than those of nCVS group，the difference was statistically significant(P<0.05).The experimental group and the number of cases of epileptic seizure cerebral vasospasm cases were higher than the control group，the difference was statistically significant(P<0.05).Conclusion EEG combined with cerebral CT perfusion imaging on subarachnoid hemorrhage(SAH)prognosis has a positive effect.
, http://www.100md.com
Key words：CTP；Electroencephalogram；Subarachnoid hemorrhage
蛛網膜下腔出血(SAH)是临床常见脑血管疾病，在脑血管病中的发病率仅次于脑梗塞、脑出血而居第三位，5%的脑卒中的病因是蛛网膜下腔出血。自发性蛛网膜下腔出血的主要病因为先天性脑动脉瘤、脑内动静脉畸形及高血压脑动脉粥样硬化。临床表现以活动中突然出现剧烈头痛呕吐、脑膜刺激症为主要症状，抽出的脑脊液为血性[1]。头颅影像学对SAH的诊断具有不可替代的作用。脑CT为蛛网膜下腔出血早期诊断提供了一种无创性的检查手段，因此为首选[2]。
脑血管痉挛(CVS)是脑血管的一种病理性变化，也是SAH后颅内常见并发症。CVS多起病隐匿，发病间歇，并表现为渐进性发作加重。调查结果显示，约70%的SAH患者会发生不同程度的CVS[3]。病理变化为颅内动静脉呈串珠样改变，血管壁收缩、痉挛，由此可导致颅内脑组织缺血和脑功能障碍，常伴有远端受累血管血流量减少。SAH后并发CVS可发展为脑梗塞，是SAH患者致残及致死的主要原因之一。DSA长期以来被认可为脑血管病变诊断的金标准，但因其价格昂贵，是一种有创性的颅内血管检查方式，患者较难接受，临床应用有一定局限性。头颅CT灌注成像(CTP)是一种功能成像，在显示脑组织形态学变化的同时反映生理功能的改变。CTP的对比剂由静脉注入，随后连续对颅内检测区域进行扫描，继而得到脑组织的时间-密度变化曲线，再应用相关的数学建模方法，得出相关灌注参数指标。CTP可以更有效、更量化地反映局部脑组织血流灌注量的改变，是蛛网膜下腔出血预后较好的评估方法。, http://www.100md.com(王淇民 王业忠 刘祺 姬云翔 代林志 董江涛 赵冬)
关键词： CTP；脑电图；蛛网膜下腔出血
中图分类号：R743.35 文献标识码：A 文章编号：1006-1959(2017)16-0041-03
, 百拇医药 Clinical Evaluation of Electroencephalogram Combined with Brain CT Perfusion Imaging in the Prognosis of Subarachnoid Hemorrhage
WANG Qi-min，WANG Ye-zhong，LIU Qi，JI Yun-xiang，DAI Lin-zhi，DONG Jiang-tao，ZHAO Dong
(Department of Neurosurgery，First Affiliated Hospital of Medical College of Shihezi University，Shihezi 832000，Xinjiang，China)
Abstract：Objective To investigate the EEG combined cerebral CT perfusion imaging on subarachnoid hemorrhage(SAH)prognosis.Methods From December 2015 to December 2016 the hospital income of 30 cases of SAH patients as the research object，will be divided into two groups，control group and experimental group.In the experimental group，SAH was detected by electroencephalogram(EEG)in brain CT perfusion imaging，and brain CT perfusion imaging was used in the control group.Observe and record the MTT，TTP，CBF，CBV，the number of cases of epileptic seizures and cerebral vasospasm(CVS)cases.Results In group CVS，MTT and TTP were higher than nCVS group，CBF group and CBV group were lower than those of nCVS group，the difference was statistically significant(P<0.05).The experimental group and the number of cases of epileptic seizure cerebral vasospasm cases were higher than the control group，the difference was statistically significant(P<0.05).Conclusion EEG combined with cerebral CT perfusion imaging on subarachnoid hemorrhage(SAH)prognosis has a positive effect.
, http://www.100md.com
Key words：CTP；Electroencephalogram；Subarachnoid hemorrhage
蛛網膜下腔出血(SAH)是临床常见脑血管疾病，在脑血管病中的发病率仅次于脑梗塞、脑出血而居第三位，5%的脑卒中的病因是蛛网膜下腔出血。自发性蛛网膜下腔出血的主要病因为先天性脑动脉瘤、脑内动静脉畸形及高血压脑动脉粥样硬化。临床表现以活动中突然出现剧烈头痛呕吐、脑膜刺激症为主要症状，抽出的脑脊液为血性[1]。头颅影像学对SAH的诊断具有不可替代的作用。脑CT为蛛网膜下腔出血早期诊断提供了一种无创性的检查手段，因此为首选[2]。
脑血管痉挛(CVS)是脑血管的一种病理性变化，也是SAH后颅内常见并发症。CVS多起病隐匿，发病间歇，并表现为渐进性发作加重。调查结果显示，约70%的SAH患者会发生不同程度的CVS[3]。病理变化为颅内动静脉呈串珠样改变，血管壁收缩、痉挛，由此可导致颅内脑组织缺血和脑功能障碍，常伴有远端受累血管血流量减少。SAH后并发CVS可发展为脑梗塞，是SAH患者致残及致死的主要原因之一。DSA长期以来被认可为脑血管病变诊断的金标准，但因其价格昂贵，是一种有创性的颅内血管检查方式，患者较难接受，临床应用有一定局限性。头颅CT灌注成像(CTP)是一种功能成像，在显示脑组织形态学变化的同时反映生理功能的改变。CTP的对比剂由静脉注入，随后连续对颅内检测区域进行扫描，继而得到脑组织的时间-密度变化曲线，再应用相关的数学建模方法，得出相关灌注参数指标。CTP可以更有效、更量化地反映局部脑组织血流灌注量的改变，是蛛网膜下腔出血预后较好的评估方法。, http://www.100md.com(王淇民 王业忠 刘祺 姬云翔 代林志 董江涛 赵冬)