摘要
目的探讨脑电双频指数监测在评估重型颅脑损伤患者预后的临床应用。方法共纳入郑州大学人民医院2014年1月至2014年12月间急诊ICU收治的52例重型颅脑损伤患者。均在入院后24h内的相同时间点开始行BIS监测1h,自入院监测BIS值5~7d,后对出院或转普通病房者进行定期随访。记录患者预后,包括死亡、植物状态（意识未恢复,但各种反射及自主呼吸良好）、致残（意识恢复,但留有后遗症,如智力障碍、语言障碍或肢体活动障碍等）、康复。分析BIS值与GCS评分的相关性。同时根据患者的BIS值,记录每个患者的预后情况,分析BIS值和预后的关系。根据预后分为三组：死亡组,意识未恢复组,意识恢复组,对比组间的BIS值,分析BIS值对重型颅脑损伤患者预后判定的敏感度和特异度。结果 BIS值与GCS评分呈正相关。52例患者中,死亡18例,植物状态15例,致残12例,康复7例。随着BIS值的升高,死亡及植物状态率逐渐降低,意识恢复率逐渐升高。结论 BIS监测在评估重型颅脑损伤患者预后方面具有重要价值。
Objective To investigate the clinical application of bispectral index monitoring in evaluating the prognosis of patients with severe traumatic brain injury. Methods A total of 52 patients with severe traumatic brain injury were treated in the emergency department of the people’s Hospital of Zhengzhou University from March 2014 to March 2015. BIS was performed at the same time point within 24 hours after admission,and the 5- 7 values were monitored for 1 hours,and then were followed up regularly after discharge or to general ward. The prognosis of the patients was recorded,including death,vegetative state（ consciousness not recovered,but all kinds of reflection and self- breathing well）,disability（ consciousness recovery,but sequelae left,such as mental retardation,language barrier or limb movement disorder,etc.）,rehabilitation. Correlation between BIS score and GCS score was analyzed. At the same time,according to the BIS value of patients,the prognosis of each patient was recorded,and the relationship between BIS and prognosis was analyzed. According to the prognosis,the patients were divided into three groups： the death group,the non- recovery group,the consciousness recovery group,the BIS values between the groups,and the sensitivity and specificity of BIS in the prognosis of patients with severe traumatic brain injury. Results The BIS score was positively correlated with GCS score. Among the 52 cases,18 cases died,15 cases of vegetative state,12 cases of disability,7 cases of rehabilitation.With the increase of BIS,the rate of death and vegetative state gradually decreased,and the recovery rate of consciousness gradually increased. Conclusion BIS monitoring has important value in evaluating the prognosis of patients with severe traumatic brain injury.
出处
《医药论坛杂志》
2016年第2期13-14,17,共3页
Journal of Medical Forum
基金
国家级临床重点专科建设项目(2013226)
关键词
重型颅脑损伤
脑电双频指数
应用
Bispectral index
Severe traumatic brain injury
Clinical application
