【摘要】 目的：探讨脑电图和经颅多普勒超声(transcranial Doppler，TCD)对慢性硬膜下血肿(chronic subdural hematoma，CSDH)钻孔引流患者预后的评估价值。方法：选取2020年1月-2021年10月粤北人民医院收治的28例CSDH患者为研究对象，所有患者均在本院进行微创钻孔外引流术治疗，并进行脑电图和TCD检查，采用Markwalder神经功能评分系统评估患者预后。比较入组患者治疗前后的脑电图检查结果和TCD检查结果[大脑中动脉(MCA)、大脑前动脉(ACA)、大脑后动脉(PCA)、椎动脉(VA)血流的平均流速]，采用Spearman相关性检验分析脑电图、TCD检查结果和神经功能评估等级的相关性。绘制受试者工作特性(ROC)曲线分析脑电图、TCD检查结果对CSDH患者预后的评估价值。结果：治疗后，患者脑电图检查结果明显改善，和治疗前相比差异有统计学意义(P<0.001)。治疗后，入组患者的MCA[(157.31±15.16)cm/s vs(139.27±12.08)cm/s]、ACA[(145.21±17.31)cm/s vs(115.49±14.33)cm/s]、PCA[(76.34±12.64)cm/s vs(56.91±9.28)cm/s]、VA[(78.60±13.61)cm/s vs(62.19±11.54)cm/s]的血流速度均显著高于治疗前，差异有统计学意义(t=4.925、6.998、6.557、4.886，P<0.001)。Spearman相关性分析结果显示，神经功能评估等级与脑电图检查异常程度呈正相关性(r=0.831，P<0.001)。神经功能评估等级与MCA(r=-0.621)、ACA(r=-0.615)、PCA(r=-0.762)、VA(r=-0.791)均呈负相关性(P<0.05)。ROC曲线分析结果显示，脑电图检查结果、MCA、ACA、PCA、VA均对CSDH患者预后具有显著的评估价值(AUC=0.854、0.882、0.847、0.844、0.861，P<0.05)。结论：脑电图和TCD可评估CSDH患者脑功能，对患者预后具有显著的评估价值。更多还原

【Abstract】 Objective:To explore the value of electroencephalogram (EEG) and transcranial Doppler (TCD) in evaluating the prognosis of patients with chronic subdural hematoma (CSDH) with drilling and drainage.Method:A total of 28 patients with CSDH treated in Yue Bei People’s Hospital from January 2020 to October 2021 were selected as the research objects,all of the patients were treated with minimally invasive drilling and external drainage in our hospital,and EEG and TCD were performed.The prognosis of patients was evaluated by Markwalder neurological function scoring system.The results of EEG and TCD[average flow velocity of middle cerebral artery (MCA),anterior cerebral artery (ACA),posterior cerebral artery (PCA) and vertebral artery (VA)]were compared before and after treatment.Spearman correlation test was used to analyze the correlation between EEG,TCD and neurological function evaluation grade.The receiver operating characteristic (ROC) curve was drawn and the prognostic value of evaluation of EEG and TCD examination results for CSDH patients were analyzed.Result:After treatment,the EEG examination results of the enrolled patients were significantly improved,and the difference was statistically significant compared with that before treatment (P<0.001).After treatment,the blood flow velocities of MCA[(157.31±15.16) cm/s vs (139.27±12.08) cm/s],ACA[(145.21±17.31) cm/s vs (115.49±14.33) cm/s],PCA[(76.34±12.64) cm/s vs (56.91±9.28) cm/s],VA[(78.60±13.61) cm/s vs (62.19±11.54) cm/s]were significantly higher than those before treatment,the differences were statistically significant (t=4.925,6.998,6.557,4.886,P<0.001).Spearman correlation analysis showed that there was a positive correlation between the evaluation grade of neural function and the abnormal degree of EEG (r=0.831,P<0.001).The grade of neurological function assessment was negatively correlated with MCA (r=-0.621),ACA (r=-0.615),PCA (r=-0.762),VA (r=-0.791) (P<0.05).ROC curve analysis showed that EEG,MCA,ACA,PCA and VA had significant prognostic value for CSDH patients (AUC=0.854,0.882,0.847,0.844,0.861,P<0.05).Conclusion:EEG and TCD can evaluate the brain function of CSDH patients,which has significant value in evaluating the prognosis of patients.更多还原