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目的 :探讨急性脑损伤患者的双侧脑电双频指数(bispectral index,BIS)与格拉斯哥评分(glasgow coma scale,GCS)、血清神经元特异性烯醇化酶(neuronspecific enolase,NSE)的相关性及其评估预后的价值。方法:采用回顾性研究方法,选取40例急诊ICU急性脑损伤致昏迷的患者。根据预后将患者分为存活组(24例)和死亡组(16例)。所有患者入ICU后48 h内行持续24 h双侧BIS监测,取双侧BIS平均值,记录患者的急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、GCS评分,并检测当日NSE值。比较两组BIS值、APACHEⅡ评分、GCS评分、NSE值,并分析BIS值与GCS评分、NSE值的相关性。结果:死亡组患者的BIS平均值及GCS评分明显低于存活组[BIS平均值:29.7±16.5 vs.49.8±8.3,P<0.05;GCS评分(分):4.1±1.1 vs.6.4±1.4,P<0.05]。死亡组患者的NSE值(ng/m L)高于存活组(74.5±18.4 vs.23.5±12.4,P<0.05)。双侧BIS平均值与GCS评分呈正相关(r=0.626,P<0.05),与NSE值呈负相关(r=-0.870,P<0.05)。结论:双侧BIS监测是评估急性脑损伤患者预后的有效指标。
Objective: To investigate the correlation between bispectral index (BIS) and glasgow coma scale (GCS) and serum neuron specific enolase (NSE) in patients with acute brain injury It evaluates the value of the prognosis. Methods: A retrospective study was conducted to select 40 patients who were unconscious after acute brain injury in ICU. According to the prognosis, the patients were divided into survival group (24 cases) and death group (16 cases). All patients underwent bilateral BIS monitoring within 24 h after ICU. The bilateral BIS monitoring was performed. The patients’ acute physiology and chronic health assessment Ⅱ (APACHE Ⅱ) score and GCS score were recorded and the NSE value of the same day was measured. The BIS value, APACHEⅡscore, GCS score and NSE value were compared between the two groups, and the correlation between BIS value and GCS score and NSE value was analyzed. Results: The mean BIS and GCS scores of death patients were significantly lower than those of survivors [mean BIS: 29.7 ± 16.5 vs.49.8 ± 8.3, P <0.05; GCS score: 4.1 ± 1.1 vs.6.4 ± 1.4, P <0.05]. The NSE value (ng / m L) in the death group was higher than in the surviving group (74.5 ± 18.4 vs.23.5 ± 12.4, P <0.05). BIS mean was positively correlated with GCS score (r = 0.626, P <0.05) and negatively correlated with NSE (r = -0.870, P <0.05). Conclusion: BIS monitoring is an effective measure to evaluate the prognosis of patients with acute brain injury.