脑电双频指数监测对重症监护病房昏迷患者预后的评估

Study of estimating the prognosis of ICU patients with coma using Bispectral index value

目的观察脑电双频指数（BIS）监测值与重症监护室（ICU）中昏迷患者预后的相关性，探讨通过BIS值评估ICU昏迷患者的预后的可行性。方法回顾『生将纳入的208例昏迷危重病患者根据所监测的BIS监测值分为四组：I组，0～20；U组，21—40；m组，41—60；IV组，〉60。分别用BIS值和神志预后（神志清楚-昏迷、植物状态、脑死亡状态）为目标，比较组间差异，计算各组BIS值与昏迷患者预后的相关性，寻找较准确评估昏迷患者预后的BIS临界值。结果四组患者的年龄、APACHEⅡ评分采用单因素方差分析，差异无统计学意义（P〉0．05），对BIS值与昏迷预后状态采用spe锄蛐’s等级相关进行相关分析，结果呈负相关（r=-n749，P=o．00），根据ROC曲线，当BIS值〉42．5对神清-昏迷状态预后评估的敏感『生及特异性较高。结论BIS值与ICU昏迷患者的预后之间具有较好的相关陛，BIS值可以对ICU昏迷患者的预后进行初步评估。

Objective To investigate the correlation between Bispectral index （BIS） value and the prognosis of patients with coma in ICU. Methods A total of 208 patients with coma in ICU were divided into 4 groups according to the BIS value. In group I, BIS value was 0 to 20; group]I, BIS value 21 to 40; group III, BIS value 41 to 60; and group IV, BIS value greater than 60. Comparison of the difference in BIS value with the differences in prognosis of patients with coma was carried out between four groups, and the prognosis of patients with coma was stratified into consciousness, coma, vegetative state, and brain death. Subsequently, the best cut- off score of BIS value calculated for determining the correlation between BIS and mental state was proposed. Results There are no significant differences in the age and APACHE 11 scores between four groups （P 〉 0. 05）. It was inverse correlation between BIS value and mental state （ r = - 0. 749, P = 0. 00）. According to the ROC curve, as BIS value was greater than 42. 5, there were higher sensitivity and specificity in Conscious-Coma patients. Conclusions BIS value is correlated with the prognosis of patients with coma in ICU, and BIS value can be a useful marker for estimating the prognosis of comatose patients.