CSI监测与CPIS评分对脑外伤昏迷合并肺部感染患者的预后判断价值  

The clinical value of CSI mornitoring and CPIS score in brain injury coma prognosis of patients with pulmonary infection

作　　者：易勇[1,2] 张跃康[1] 周章明[2] 淡冰[2] 梁张[2] 余水[2] 王强平[2] 

机构地区：[1]四川大学华西医院神经外科,四川成都610041 [2]都江堰市医疗中心神经外科,四川都江堰611800

出　　处：《西部医学》2016年第6期811-814,共4页Medical Journal of West China

基　　金：四川省卫生和计划生育委员会科研课题(140026)

摘　　要：目的探讨大脑状态指数监测（Cerebral State Index,CSI）与肺部感染评分（Clinical Pulmonary Infection Score,CPIS）对脑外伤昏迷合并肺部感染患者的预后判断价值。方法选择都江堰市人民医院156例脑外伤昏迷合并肺部感染患者156例为研究对象,根据病情随机分为A、B两组各78例,A组给予CSI监测,B组在CSI监测的同时进行CPIS评分,根据评分制定患者治疗方案。结果 1A组经CSI监测分级为10-30、30-50、50-80、80-100的分别占本组的30.8%、41.0%、21.8%和6.4%,30-50、50-80、80-100与10-30相比,差异均有统计学意义（均P〈0.05）。2B组CSI监测四级分布分别为37.2%、30.8%、24.4%和7.7%,30-50、50-80、80-100与10-30相比,差异亦有统计学意义（均P〈0.05）。3B组CSI评分越高,CPIS评分越低,CSI与CPIS之间呈负相关。4就存活时间而言,两组间CSI评分差异无显著性（P〉0.05）;B组死亡率明显高于A组,平均重症监护时间、住院时间及感染控制时间均长于A组,二者间差异均有统计学意义（均P〈0.05）。结论 CSI监测与CPIS评分在评估脑外伤昏迷合并肺部感染患者情况时呈负相关,二者联合应用提高了对脑外伤昏迷合并肺部感染患者预后判断的准确性,值得临床推广应用。Objective To evaluate the clinical value of brain states index monitoring（Cerebral State Index,CSI）and pulmonary infection score（Clinical Pulmonary Infection Score,CPIS）in brain trauma coma complicated with pulmonary infection.Methods 156 patients with traumatic brain injury coma complicated with pulmonary infection were randomly divided into Group A and Group B.Group A was treated with CSI monitoring and group B with CSI monitoring.Results The rate of Group A of 10 to 30,30-50,50-80and 80-100graded by CSI were 30.8%,41.0%,21.8%and 6.4%,respectively.The difference between the last three ranks and the first one was significant（P〈0.05）.The rate of Group B of 10 to 30,30 - 50,50 - 80 and 80 - 100 graded by CSI were 37.2%,30.8%,24.4% and 7.7%,respectively.the last three ranks and the first one was significant（P〈0.05）.For the ratio of survival between the two groups,CSI score had no significant difference（P〈0.05）.The mortality of group B was significantly lower than that of group A,and the average time of ICU,hospitalization and infection control time of group B was shorter than that of group A.The differences were significant（P〈0.05）.Conclusion CSI and CPIS score was negatively correlated when monitoring brain injury coma patients with pulmonary infection.The combination of CSI and CPIS can be applied for prognosis in the clinical practice.

关 键 词：CSI CPIS 脑外伤昏迷 肺部感染 预后 

分 类 号：R651.15[医药卫生—外科学]