脑电双频指数在大面积脑梗死昏迷患者中的临床应用  

Application of bispectral index monitoring inpatients with coma due to massive cerebral infarction

作　　者：牛世芹[1] 袁俊亮[1] 李海英[1] 王姝梅[1] 李淑娟[1] 刘芳[2] 李向红[2] 岳云[2] 胡文立[1] 

机构地区：[1]首都医科大学附属北京朝阳医院神经内科,100020 [2]首都医科大学附属北京朝阳医院麻醉科,100020

出　　处：《中华老年心脑血管病杂志》2012年第6期564-566,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：北京市卫生系统高层次卫生技术人才资助项目(2009-3-09)

摘　　要：目的探讨应用脑电双频指数(BIS)评估大面积脑梗死导致昏迷患者病情严重程度的可靠性及其与预后的关系。方法选择大面积脑梗死导致昏迷的患者30例,分为生存组20例和死亡组10例,记录BIS_(min)、BIS_(max),计算BIS_(mean)。同时动态监测生命体征、临床症状体征、评价格拉斯哥昏迷评分。随访3个月,评估格拉斯哥结局和格拉斯哥昏迷评分,以出院后3个月内有无死亡为终点评价指标。结果与生存组住院时间(30.2±5.1)d比较,死亡组住院时间(41.0±7.3)d明显延长(P<0.01);死亡组BIS_(min)、BIS_(max)、BIS_(mean)分别为45.1±1 9.2、51.1±20.0、48.1±19.5,生存组分别为69.1±1 3.6、74.5±1 3.0、71.8±1 3.1,死亡组BIS_(min)、BIS_(max)、BIS_(mean)较生存组明显降低(P<0.01)。死亡组BIS_(max)与格拉斯哥结局评分呈正相关(r=0.486,P=0.03)。结论 BIS能直接、客观的反映大面积脑梗死昏迷患者脑损伤的严重程度,可准确、可靠地预测昏迷患者的预后,具有潜在的临床应用价值。Objective To study the application of bispectral index monitoring（BIS） in patients with coma due to massive cerebral infarction and its relation with the prognosis of such patients. Methods Thirty patients with coma due to massive cerebral infarction were divided into survival group （n=20）and death group（n= 10）. Their BISmin ,BISmax and BIS were recorded, and their vital signs,clinical symptoms and signs,Glasgow outcome scale（GOS）-based coma score were monitored. The patients were followed up for 3 months, during which their coma was scored according to the GOS. Whether death occurred within 3 months after the patients were discharged was used as the end assessment indication. Results The average hospital stay time was significantly longer in death group than in survival group（41.0±7.3 d vs 30.2±5. 1 d,P〈0.01）. The BISmin,BISmax and BIS were significantly lower in death group than in survival group（45.1±19.2 vs 69.1 ± 13.6,51.1±20.0 vs 74.5±13.0,48.1±19.5 vs 71.8±13.1,P〈0. 01）. The BISmax was positively related with the GOS-based coma score in death group（r=0. 486,P=0.03）. Conclusion BIS can directly and objectively show the severity of cerebral injury in patients with coma due to massive cerebral infarction,accurately and reliably predict their prognosis,and is thus of a potential application value in clinical practice.

关 键 词：脑梗死 格拉斯哥昏迷量表 脑电描记术 脑损伤 预后 

分 类 号：R614[医药卫生—麻醉学]