脑电双频指数对弥漫性轴索损伤患者脑损伤及预后的评估价值分析

Analyze the evaluation value of bispectral index on brain injury and prognosis in patients with diffuse axonal injury

目的分析脑电双频指数(bispectral index,BIS)对弥漫性轴索损伤患者脑损伤及预后的评估价值。方法回顾性收集2015年1月~2020年12月我院神经外科收治的80例弥漫性轴索损伤患者的临床资料,根据患者预后分为预后良好组(33例)和预后不良组(47例),比较两组一般资料、BIS值、格拉斯哥昏迷(Glasgow Coma Scale,GCS)评分及血清神经元特异性烯醇酶(neuron specific enolase,NSE)、S100水平;根据BIS值将患者分为BIS值0~40组(33例)、BIS值41~60组(25例)、BIS值≥61组(22例),比较三组一般资料、GCS评分及血清NSE和S100水平。结果预后良好组机械通气患者占比(18.18%)显著低于预后不良组(40.43%,P<0.05)。预后良好组BIS值、GCS评分高于预后不良组(P<0.05),而血清NSE、S100水平低于预后不良组(P<0.05)。BIS值≥61组机械通气患者占比(9.09%)显著低于BIS值0~40组和BIS值41~60组(45.45%和32.00%,P<0.05)。GCS评分比较,BIS值41~60组、BIS值≥61组高于BIS值0~40组(P<0.05);血清NSE、S100水平比较,BIS值≥61组低于BIS值0~40组、BIS值41~60组(P<0.05),BIS值41~60组低于BIS值0~40组(P<0.05)。结论预后良好的弥漫性轴索损伤患者具有较高的BIS值,同时随着患者BIS值降低,患者血清NSE、S100水平升高,说明BIS值可用于弥漫性轴索损伤脑损伤和预后的早期评估。

Objective To analyze the evaluation value of bispectral index(bispectral index, BIS) on evaluating brain injury and prognosis in patients with diffuse axonal injury.Methods The clinical data of 80 patients with diffuse axonal injury treated in neurosurgery department of our hospital from January 2017 to December 2020 were retrospectively collected.According to their prognosis, they were divided into the good prognosis group(33 cases) and the poor prognosis group(47 cases).The general data, BIS value, the score of glasgow coma scale(Glasgow Coma Scale, GCS) and the levels of serum neuron-specific enolase(neuron specific enolase, NSE) and S100 were compared between the two groups.According to BIS value, the patients were divided into the BIS value 0~40 group(33 cases),the BIS value 41~60 group(25 cases) and the BIS value ≥61 group(22 cases).The general data, the score of GCS and the levels of serum NSE and S100 of the three groups were compared..Results The proportion of patients with mechanical ventilation in the good prognosis group(18.18%) was significantly lower than that in the poor prognosis group(40.43%,P<0.05).BIS value and the score of GCS in the good prognosis group were higher than those in the poor prognosis group(P<0.05),while the levels of serum NSE and S100 in the good prognosis group were lower than those in the poor prognosis group(P<0.05).The proportion of mechanical ventilation patients with the BIS value ≥61 group(9.09%) was significantly lower than those with the BIS value 0~40 group and the BIS value 41~60 group(45.45% and 32.00%,P<0.05).Comparing the score of GCS,the BIS value 41~60 group and the BIS value ≥61 group were higher than those of the BIS value 0~40 group(P<0.05).Compared with the levels of serum NSE and S100,the BIS value ≥61 group was lower than the BIS value 0~40 group and the BIS value 41~60 group(P<0.05),and the BIS value 41~60 group was lower than the BIS value 0~40 group(P<0.05).Conclusion Patients with diffuse axonal injury with good prognosis had higher BIS value, and with the decrease of BIS value, the levels serum NSE and S100 increase, indicating that BIS value could be used for early evaluation of brain injury and prognosis of diffuse axonal injury.