李雪莲　叶兰香　刘娟娟　罗政　陈俊斌　谷玉平

【摘要】 目的：探討早期检测短潜伏期体感诱发电位（SLSEP）在脑出血（ICH）治疗后遗留肢体运动障碍程度及预后评估中的应用价值。方法：对2018年1月-2019年12月本院收治的150例ICH患者的临床资料进行回顾性分析。根据治疗4周后遗留运动障碍程度，将患者分为中度以下组（n=101）与中重度组（n=49），比较两组SLSEP，分析早期SLSEP对遗留运动障碍的预测价值。同时，根据患者治疗4周后的生存情况，将患者分为生存组（n=123）及死亡组（n=27），比较两组早期SLSEP，分析SLSEP对患者生存情况的预测价值。结果：中度以下组N9潜伏期及N20潜伏期均短于中重度组，而N9波幅及N20波幅均高于中重度组（P<0.05）。N9潜伏期、N20潜伏期、N9波幅及N20波幅对遗留运动障碍程度具有预测价值（P<0.05），N9潜伏期<11.31 ms、N20潜伏期<23.36 ms、N9波幅>1.19 μV及N20波幅>1.25 μV时，对患者遗留中度以下运动障碍的预测准确率较高。同时，存活组N9潜伏期及N20潜伏期均短于死亡组，N9波幅及N20波幅均高于死亡组（P<0.05）;且N9潜伏期、N20潜伏期、N9波幅及N20波幅对患者的生存情况具有预测价值（P<0.05），N9潜伏期<10.15 ms、N20潜伏期<23.96 ms、N9波幅>1.22 μV及N20波幅>1.19 μV时，对患者的生存状况预测准确率较高。结论：早期检测SLSEP对于ICH患者治疗后遗留运动障碍及生存情况均具有显著的预测价值。

【关键词】 脑出血 短潜伏期体感诱发电位 肢体运动障碍程度

[Abstract] Objective： To investigate the application value of early detection of short latency somatosensory evoked potential （SLSEP） in the assessment of residual limb movement disorders and prognosis after treatment of intracerebral hemorrhage （ICH）. Method： Clinical data of 150 ICH patients admitted to our hospital from January 2018 to December 2019 were retrospectively analyzed. According to the degree of residual movement disorders after 4 weeks of treatment， the patients were divided into below moderate group （n=101） and moderate to severe group （n=49）. SLSEP of two groups were compared to analyze the predictive value of early SLSEP for residual movement disorders. Meanwhile， according to the survival of the patients after 4 weeks of treatment， the patients were divided into the survival group （n=123） and the death group （n=27）， and the early SLSEP of two groups were compared to analyze the predictive value of SLSEP for the survival of the patients. Result： The N9 latency and N20 latency in the below moderate group were shorter than those in the moderate to severe group， and the N9 amplitude and N20 amplitude in the below moderate group were higher than those in the moderate to severe group （P<0.05）. The N9 latency， N20 latency， N9 amplitude， and N20 amplitude had predictive value for the degree of residual movement disorder （P<0.05）. With the N9 latency<11.31 ms， N20 latency<23.36 ms， N9 amplitude>1.19 μV， and N20 amplitude>1.25 μV， the prediction accuracy of patients with residual below moderate motor impairment was higher. At the same time， the N9 latency and N20 latency in the survival group were shorter than those in the death group， and the N9 amplitude and N20 amplitude in the survival group were higher than those in the death group （P<0.05）. In addition， the N9 latency， N20 latency， N9 amplitude， and N20 amplitude had predictive value for the survival of patients （P<0.05）. With the N9 latency<10.15 ms， N20 latency<23.96 ms， N9 amplitude>1.22 μV， and N20 amplitude>1.19 μV， the prediction accuracy of patients with survival was higher. Conclusion： Early detection of SLSEP has significant predictive value for residual movement disorders and survival of patients with ICH after treatment.

[Key words] Intracerebral hemorrhage Short latency somatosensory evoked potential Degree of limb movement disorder

First-authors address： Yue Bei Peoples Hospital of Shantou University Medical College， Shaoguan 512026， China

doi：10.3969/j.issn.1674-4985.2021.09.036

脑出血（ICH）为临床常见的脑血管疾病之一，本病不仅具有较高的发病率，同时也具有较高的致残率及病死率，预后较差[1-2]。近年来临床观察显示，在ICH的治疗中，不同的干预时间及治疗方案对预后的影响较大，故准确判定患者的病情及预后，对治疗方案的制定有着十分重要的作用[3-4]。目前临床工作中仍主要以各类神经功能评分对ICH患者的病情及预后进行评价，但其常可受主观因素影响而影响评估准确性[5-6]。本研究选……