新疆医科大学学报

目的探讨脑电图(Electroencephalogram,EEG)在脑梗死患者诊断中的应用价值。方法选择神经外科因外伤收住但脑CT正常的170例病人作为对照组。经CT分型证实脑梗死面积超过一个脑叶、>50 mm的162例病人作为大面积脑梗死组,脑梗死面积<50 mm的158例病人作为小面积脑梗死组。对3组病例的EEG检查结果进行比较,同时对大面积脑梗死患者24 h内以及24~48 h进行CT检查的阳性率和相同时间段EEG检查结果的阳性率进行比较。结果大面积脑梗死组EEG正常10例,EEG轻度异常19例,EEG中度异常84例,EEG重度异常49例。小面积脑梗死组EEG正常28例,EEG轻度异常80例,EEG中度异常40例,EEG重度异常10例。2组脑梗死患者EEG比较差异有统计学意义(P<0.05),2组EEG与对照组相比差异也具有统计学意义(P<0.05)。24 h内大面积脑梗死组EEG阳性率和脑CT检查结果阳性率相比较,差异有统计学意义(P<0.05),而24~48 h EEG和脑CT检查阳性率相比较差异无统计学意义(P>0.05)。结论 EEG对早期CT排除出血而未能显示梗死灶的脑梗死诊断价值较CT大,CT与EEG联合检查,可以更好地为脑梗死的诊断和治疗提供客观的依据。

Objective To investigate the application of electroencephalogram(EEG) in the diagnosis of cerebral infarction.Methods 320 patients with cerebral infarction diagnosed by CT were divided into large area cerebral infarction group of 162 cases and small area cerebral infarction group of 158 cases according to the size of infarction.Meanwhile 170 cases with cerebral trauma but had normal CT scan were chosen as control group.A comparison of EEG between the three groups was made.And the positive rate of CT was compared with the positive rate of EEG in the large area cerebral infarction group within 24 hours and at 24～48 hours.Results In 162 cases with large area cerebral infarction,10 cases showed normality on EEG,19 cases with slight abnormality,84 cases with moderate abnormality and 49 cases with severe abnormality,respectively.In 158 cases with small area cerebral infarction,28 cases showed normality on EEG,80 cases with slight abnormality,40 cases with moderate abnormality and 10 cases with severe abnormality,respectively.The positive rate of EEG in large area cerebral infarction group was higher than those in small area cerebral infarction group(P<0.05).The positive rate of EEG in two groups with cerebral infarction were higher than those in control group(P<0.05).In the large area cerebral infarction group,the positive rate of EEG was higher than that of CT within 24 hours(P<0.05),but there was no statistical significance in the positive rate between EEG and CT at 24~48 hours(P>0.05).Conclusion Although EEG cannot directly show the spot and degree of cerebral infarction,it reflects changes in brain function which appear before CT findings.The application of CT with combination of EEG could provide more reliable objective evidence for clinical diagnosis and treatment of cerebral infarction.