早期脑电双频指数监测联合乳酸清除率与急性重度一氧化碳中毒迟发性脑病的相关性研究  

Correlation between early eeg dual-frequency index monitoring combined with lactic acid clearance rate and delayed encephalopathy with acute severe carbon monoxide poisoning

作　　者：刘永建[1] 刘桓 王双豹 肖青勉[1] 孙爱慧 李雅琴[1] 王维展[1] Liu Yongjian;Liu Huan;Wang Shuangbao;Xiao Qingmian;Sun Aihui;Li yaqin;Wang Weizhan(Harrison International Peace Hospital of Hebei Medical University,Hengshui 053000,China)

机构地区：[1]河北医科大学哈励逊国际和平医院,衡水053000

出　　处：《中华劳动卫生职业病杂志》2021年第4期258-261,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：河北省医学科学研究课题项目(20200405)。

摘　　要：目的分析早期脑电双频指数(BIS)监测联合乳酸清除率(LCR)与急性重度一氧化碳中毒(ASCMP)迟发性脑病的相关性及预测价值。方法于2020年3月,选取2019年10月~2020年3月河北医科大学哈励逊国际和平医院收治的96例ASCMP患者进行回顾性分析,随访60 d,按患者转归分为急性一氧化碳中毒迟发性脑病(DEACMP)组与预后良好组,比较两组一般资料、入院24 h BIS均值及治疗24 h LCR,根据24 h LCR检测结果将患者分为高LCR组(LCR>15%)及低LCR组(LCR≤15%),分析BIS均值、LCR与DEACMP的相关性及两者单独及联合对DEACMP的预测价值,比较高LCR组与低LCR组患者临床资料。BIS、LCR及两者联合对DEACMP预测用受试者工作特征曲线(ROC曲线)。结果与预后良好组比较,DEACMP组患者入院24 h BIS均值和治疗24 h LCR均明显较低,差异有统计学意义(P<0.05)。与低LCR组比较,高LCR组患者DEACMP患病率明显较低,差异有统计学意义(P<0.01);早期BIS均值、LCR与DEACMP均呈负相关性(r=0.760、0.546,P<0.01),BIS均值、LCR及两者联合对DEACMP预测的ROC曲线下面积分别为0.799、0.847和0.902。结论临床可通过早期BIS与LCR联合检测为ASCMP患者预后评估提供有效指导。Objective To analyze the correlation and predictive value between early BIS monitoring combined with lactic acid resolution(LCR)and delayed encephalopathy with acute severe carbon monoxide poisoning(ASCMP).Methods Select 96 cases of our hospital ASCMP patients were analyzed retrospectively in March 2020,and follow-up of 60 days,according to the outcome in patients with acute carbon monoxide poisoning(DEACMP)delayed encephalopathy group with good prognosis,compare two groups of general information,admission BIS average 24 h and 24 h after treatment the LCR,According to the 24h LCR test results,patients were divided into high LCR group(LCR>15%)and low LCR group(LCR≤15%),analysis the BIS average,the correlation of the LCR with DEACMP and both individual and joint of DEACMP predictive value,Comparing clinical data of patients with high LCR and low LCR.Results The mean BIS value of the DEACMP group 24 hours after admission was significantly lower than that of the group with good prognosis(P<0.05).LCR of DEACMP group was significantly lower than that of the group with good prognosis after 24 h treatment(P<0.05).The prevalence of DEACMP in patients with high LCR was significantly lower than that with low LCR(P<0.01);In the early stage,BIS mean,LCR and DEACMP were negatively correlated(P<0.05),and the area under the curve predicted by BIS mean,LCR and their combination on DEACMP was 0.799,0.847 and 0.902,respectively.Conclusion Early BIS monitoring combined with LCR has a significant correlation with DEACMP,and the combined effect of the two is better.Early BIS combined with LCR detection can provide effective guidance for the prognosis assessment of ASCMP patients.

关 键 词：监测 中毒 脑电双频指数 乳酸清除率 重度一氧化碳中毒 急性 迟发性脑病 

分 类 号：R595.1[医药卫生—内科学] R747.9[医药卫生—临床医学]