脑状态指数联合中枢神经系统感染评分表在重型脑外伤并发颅内感染患者中的应用

Application of brain state index combined with central nervous system infection scale in patients with severe brain injury complicated with intracranial infection

目的探讨脑状态指数(CSI)联合中枢神经系统(CNS)感染评分表在重型脑外伤并发颅内感染患者病情监测中的应用。方法选取2018年6月至2019年6月开封市中心医院神经外科收治的重型脑外伤患者78例,采用CSI评分及CNS评分对患者病情进行评估。结果CSI评分10~30分组、31~50分组、51~80分组、CNS评分0~13分组、14~26分组、27~39分组在性别、年龄、脑挫裂伤、颅内血肿等方面比较差异均无统计学意义(均P>0.05),而CSI评分10~30分组、31~50分组、51~80分组在颅内感染发生率、死亡率、格拉斯哥预后评分(GOS)、Barthel指数差异均有统计学意义(均P<0.05)。CNS评分0~13分组、14~26分组、27~39分组颅内感染发生率及死亡率差异均有统计学意义(均P<0.05)。经Pearson单因素分析可知,CSI评分与CNS评分呈负相关(P<0.05)。结论CSI评分联合CNS评分对重型脑外伤并发颅内感染患者病情判断及预后有重要的价值,可为患者实施预见性护理提供指导,从而降低重型脑外伤患者颅内感染率及死亡率,提高患者临床治疗效果。

Objective To investigate the application of cerebral state index(CSI)combined with central nervous system(CNS)infection score in the monitoring of patients with severe traumatic brain injury complicated with intracranial infection.Methods A total of 78 patients with severe brain injury admitted to the neurosurgery department of this hospital from June 2018 to June 2019 were selected.The conditions of the patients were evaluated by CSI score and CNS score.Results There were no significant differences in gender,age,brain contusion and intracranial hematoma among CSI scores of 10~30,CIS scores of 31~50,CIS scores of 51~80,CNS scores of 0~13,CNS scores of 14~26,and CNS scores of 27~39(P>0.05).There were significant differences in the incidence of intracranial infection,mortality,Glasgow Outcome Score(GOS)and Barthel index among CSI scores 10~30 groups and 31~50 groups and 51~80 groups(P<0.05).There were differences in the incidence and mortality of intracranial infection between CNS scores 0~13,14~26,and 27~39(P<0.05).According to Pearson univariate analysis,CSI score was negatively correlated with CNS score(P<0.05).Conclusions CSI score combined with CNS score is of great value in the judgment and prognosis of patients with severe traumatic brain injury complicated with intracranial infection.It can provide guidance for patients to implement predictive nursing,thus reducing the intracranial infection rate and mortality of patients with severe traumatic brain injury,and improve the clinical treatment of patients.