脑电双频指数评估心肺复苏后患者的预后

Assessment the prognosis of patients after cardiopulmonary resuscitation with bispectral index.

目的探讨脑电双频指数（BIS）监测在评估心肺复苏后患者预后的意义。方法选择32例心肺复苏后72h仍然昏迷的患者，行BIS监测，并行格拉斯哥评分（GCS）及急性生理及慢性健康状况评分系统（APACHEⅡ），将BIS值与GCS评分、APACHE Ⅱ评分进行相关性分析。将患者分为2组：预后良好组（n=7）；预后不良组（n=25），比较两组的BIS值、GCS评分、APACHE Ⅱ评分。计算BIS的曲线下面积及对预后判断的截点。结果本组患者30d存活率31．25％。BIS值与GCS评分呈明显正相关（r=0．707，P=0．000）；预后良好组与预后不良组的BIS值比较，差异具有统计学意义（P=0．000）。BIS曲线下面积为0．943，当BIS≤60时，其预测心肺复苏后患者发生预后不良的敏感度为100％；特异度为88％。结论BIS监测可作为心肺复苏后患者预后评估的一个指标。

Objective To study the value of bispectral index （BIS） in predicting the prognosis of patients after cardiopulmonary resuscitation （CPR）. Methods Thirty-two coma patients 72 hours after CPR were enrolled for study with monitoring the changes of BIS , glasgow coma scale （GCS） and acute physiology and chronic health evaluation scoring system （ APACHE Ⅱ）, and subsequently the monitored data were documented and analyzed. The patients were divided into 2 groups ： good prognosis group （ n = 7 ） and poor prognosis group （ n = 25 ）, and comparisons of BIS, GCS and APACHE 11 were made between two groups . The area under the curve （ ROC, AUC） of BIS and the intercept point for assessing prognosis were calculated. Results The 30 - day survival rate in this study was 31.25%. The positive correlation between the values of BIS and GCS were obvious （ r = 0. 707, P = 0. 000 ）. Comparison of BIS between two groups showed difference was statistically significance （P = 0. 000）. The area under the ROC of BIS was 0. 943. When BIS ≤ 60, the sensitivity of predicting poor prognosis of patients after CPR was 100% ; the specificity was 88%. Conclusions BIS monitoring could be a high sensitive indicator of evaluating prognosis of patients after cardiopulmonary resuscitation.