高血压脑出血昏迷患者脑功能状态监测的临床研究

Cerebral state monitor in comatose patients after hypertensive intracerebrai hemorrhage

目的探讨高血压脑出血后昏迷患者脑功能状态监测的应用及其对预后评估的作用。方法回顾性分析119例基底节区高血压脑出血后昏迷患者的临床资料及脑功能状态l监测数据．根据随访3个月的预后情况将患者分为清醒、昏迷及死亡3组，比较各组患者在入院时、人院后第3天、第7天及第14天时脑状态指数（CSI）的差异性及变化情况。结果119例患者入院时的CSI值与GCS评分呈正相关关系（Spearman相关系数rp=0．816，P=0.000）。各组患者发病后不同时间CSI值有差别．清醒组CSI值最高，昏迷组最低，统计分析显示各组患者在入院时、入院后第3天、第7天及第14天时CSI值差异均有统计学意义（P〈0．05）。结论脑功能状态监测可以反映患者的脑功能状态水平，在临床上应用CSI值连续监测高血压脑出血后昏迷患者的脑功能状态有助于预后评估及指导诊治。

Objective To explore the application of cerebral state monitor in comatose patients after hypertensive intracerebral hemorrhage, and its effect on the assessment of prognosis. Methods Retrospective analysis was performed on the clinical data and the cerebral monitoring data of 119 comatose patients after hypertensive intracerebral hemorrhage in the basal ganglia. During the 3 months of follow-up, these patients were divided into 3 groups according to their prognoses： resuscitation group, coma group and death group. The difference and diversification of cerebral state index （CSI） on the admission, 3rd, 7th and 14th d after admission were compared between the 3 groups. Results The CSI and the GCS scores of these 119 patients on admission showed positive correlation （Spearman＇s correlation coefficient rj,= 0.816, P=-0.000）. The CSI was significantly different between each 2 groups at different times with the highest level in the resuscitation group and the lowest level in the coma group. The CSI on admission, 3rd, 7th and 14th d after admission showed significant difference among the 3 groups （P〈0.05）. Conclusion Cerebral state monitor can reflect the function of brain. Monitoring the brain function of the comatose patients after hypertensive intracerebral hemorrhage with CSI is helpful in assessing the prognosis and guiding the clinical treatment.