监测脑状态指数与颅脑外伤患者脑功能损害程度及意识状态的关系分析

Relationship between monitoring brain state index and brain function damage and consciousness state in patients with craniocerebral trauma

目的探讨监测脑状态指数(CSI)与颅脑外伤患者脑功能损害程度及意识状态的关系。方法选取2017年2月至2019年2月在新乡市中心医院治疗的颅脑外伤患者260例,对所有患者均进行格拉斯哥昏迷评分(GCS),并按照GCS评分的不同分为清醒到深昏迷意识状态,比较不同意识状态患者的GCS评分。另采用脑状态监测仪对所有患者的CSI值进行检测,比较不同意识状态患者的CSI值并作相关性分析。通过受试者工作特征(ROC)曲线分析CSI诊断颅脑外伤患者意识状态的价值。结果意识状态为清醒到深昏迷患者的GCS评分呈逐渐降低趋势,且经单因素方差分析,各组间比较差异均有统计学意义(P<0.05)。意识状态为清醒到深昏迷患者的CSI值呈逐渐降低趋势,经单因素方差分析,各组间比较差异均有统计学意义(P<0.05)。经Pearson相关性分析,颅脑外伤患者CSI值与GCS、意识状态均呈正相关关系(P<0.05)。经ROC曲线分析,CSI值诊断清醒到深昏迷患者的灵敏度、特异度较高(P<0.05)。结论 CSI指数与颅脑外伤患者脑功能损害程度及意识状态存在密切相关,通过对CSI指数进行监测有利于诊断脑功能损害程度。

【Objective】 To study and analyze the relationship between the monitoring of brain state index(CSI) and the degree of brain function damage and consciousness state in patients with craniocerebral trauma. 【Methods】 A total of 260 patients with craniocerebral trauma treated in our hospital from February 2017 to February 2019 were selected as subjects for observation.Glasgow Coma Score(GCS) was performed on all patients. According to GCS scores, the patients were divided into conscious state and deep coma state. The GCS scores of patients with different states of consciousness were compared. The CSI value of patients was detected by the brain state monitor and compared among patients with different states of consciousness, then correlation analysis was done. The value of CSI in diagnosing the consciousness state in patients with craniocerebral trauma was analyzed by ROC curve.【Results】 The GCS score of patients with conscious state from wakeful state to deep coma showed a gradually decreasing trend,and it could be concluded by one-way analysis of variance(ANOVA) that the difference between the groups was statistically significant(all P<0.05). The CSI value of patients with conscious state from wakefulness to deep coma showed a gradually decreasing trend, and it could be concluded by one-way ANOVA that the difference between the groups was statistically significant(all P<0.05). According to Pearson correlation analysis, CSI value of patients with craniocerebral trauma was positively correlated with GCS and consciousness state(all P<0.05). After ROC curve analysis, the sensitivity and specificity of CSI value in the diagnosis of patients with wakefulness to deep coma were higher(all P<0.05). 【Conclusion】 CSI index is closely related to the degree of brain function damage and state of consciousness in patients with craniocerebral trauma. Monitoring CSI index is helpful to diagnose the degree of brain function damage.