急性重度一氧化碳中毒患者脑电双频指数监测的临床意义  

Clinical significance of bispectral index monitoring in patients with acute severe carbon monoxide poisoning

作　　者：李佳[1] 李隆 刘永建[1] 王维展[1] Li Jia;Li Long;Liu Yongjian;Wang Weizhan(Department of Emergency Medicine,Harrison International Peace Hospital Affiliated to 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急救医学部,衡水053000

出　　处：《中华劳动卫生职业病杂志》2022年第5期337-340,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：衡水市科学技术研究与发展计划项目(2021014077Z)。

摘　　要：目的:分析脑电双频指数(BIS)与急性重度一氧化碳中毒(ASCMP)患者预后的相关性及其对患者不良结局的预测价值。方法:于2021年3月,以2019年1月至2020年12月就诊于河北医科大学哈励逊国际和平医院的106例ASCMP患者为研究对象,所有患者入院行24 h BIS监测,根据患者60 d后神经功能预后分为预后良好组( n=75)和预后不良组( n=31)。比较两组患者一般情况、急性生理与慢性健康Ⅱ(APACHEⅡ)评分、入院格拉斯哥昏迷量表(GCS)评分及24 h BIS均值。采用Pearson相关分析法分析患者24 h BIS均值与入院GCS评分、APACHEⅡ评分及昏迷时间的相关性。绘制受试者工作特征(ROC)曲线分析24 h BIS均值、入院GCS评分、APACHEⅡ评分以及昏迷时间对ASCMP患者不良结局的预测价值。 结果:预后不良组患者昏迷时间和APACHEⅡ评分明显高于预后良好组,入院GCS评分和24 h BIS均值明显低于预后良好组( P<0.05)。Pearson相关性分析显示,患者24 h BIS均值与入院GCS评分呈正相关性,与APACHEⅡ评分、昏迷时间呈负相关( r=0.675、-0.700、-0.565, P<0.001)。24 h BIS均值对ASCMP患者不良结局的预测价值最高,截断值为74,曲线下面积为0.883(95% CI:0.814~0.951, P<0.001),灵敏度和特异度分别为73.3%和87.1%。 结论:24 h BIS均值与ASCMP患者急性脑神经损伤、病情严重程度及昏迷时间有良好的相关性,对ASCMP患者不良结局具有较高的预测价值。Objective To analyze the correlation of bispectral index(BIS)with the prognosis of patients with acute severe carbon monoxide poisoning(ASCMP)and its predictive value of adverse outcomes.Methods In March 2021,106 ASCMP patients who were treated in Harrison International Peace Hospital Affiliated to Hebei Medical University from January 2019 to December 2020 were taken as research objects.All patients underwent 24-hour BIS monitoring after admission,and were divided into good prognosis group(n=75)and poor prognosis group(n=31)according to the prognosis of the patients'cranial nerve function after 60 d.The general conditions,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,Glasgow Coma Scale(GCS)score at admission and 24-hour BIS mean were compared between the two groups.Pearson correlation analysis was used to analyze the correlations between the 24-hour BIS mean and GCS score at admission,APACHEⅡscore and coma time.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of 24-hour BIS mean,GCS score at admission,APACHEⅡscore and coma time on adverse outcome of ASCMP patients.Results The coma time and APACHEⅡscore of the patients in the poor prognosis group were significantly higher than those in the good prognosis group,the GCS score at admission and 24-hour BIS mean were significantly lower than those in the good prognosis group(P<0.05).Pearson correlation analysis showed that the 24-hour BIS mean was positively correlated with the GCS score at admission,and negatively correlated with the APACHEⅡscore,coma time(r=0.675,-0.700,-0.565,P<0.001).The 24-hour BIS mean had the highest predictive value for adverse outcome of ASCMP patients,with a cut-off value of 74,the area under the curve was 0.883(95%CI:0.814-0.951,P<0.001),and the sensitivity and specificity were 73.3%and 87.1%,respectively.Conclusion The 24-hour BIS mean has a good correlation with the acute brain nerve injury,the severity of the disease and coma time of patients with ASCMP.And it has a hig

关 键 词：一氧化碳中毒 脑电双频指数 监测 预测 

分 类 号：R595.1[医药卫生—内科学]