脑电双频指数评估心肺复苏后患者的预后

摘要

目的 探讨脑电双频指数(BIS)监测在评估心肺复苏后患者预后的意义.方法 选择32例心肺复苏后72 h仍然昏迷的患者,行BIS监测,并行格拉斯哥评分(GCS)及急性生理及慢性健康状况评分系统(APACHEⅡ),将BIS值与GCS评分、APACHEⅡ评分进行相关性分析.将患者分为2组:预后良好组(n=7)；预后不良组(n=25),比较两组的BIS值、GCS评分、APACHEⅡ评分.计算BIS的曲线下面积及对预后判断的截点.结果 本组患者30 d存活率31.25％.BIS值与GCS评分呈明显正相关(r=0.707,P=0.000);预后良好组与预后不良组的BIS值比较,差异具有统计学意义(P =0.000).BIS曲线下面积为0.943,当BIS≤60时,其预测心肺复苏后患者发生预后不良的敏感度为100％；特异度为88％.结论 BIS监测可作为心肺复苏后患者预后评估的一个指标.%Objective To study the value of bispectral index (BIS) in predicting the prognosis of patients after cardiopulmonary resuscitation (CPR).Methods Thirty-two coma patients 72 hours after CPR were enrolled for study with monitoring the changes of BIS,glasgow coma scale (GCS) and acute physiology and chronic health evaluation scoring system (APACHE Ⅱ),and subsequently the monitored data were documented and analyzed.The patients were divided into 2 groups:good prognosis group (n =7)and poor prognosis group (n =25),and comparisons of BIS,GCS and APACHE Ⅱ were made between two groups.The area under the curve (ROC,AUC) of BIS and the intercept point for assessing prognosis were calculated.Results The 30-day survival rate in this study was 31.25 ％.The positive correlation between the values of BIS and GCS were obvious (r =0.707,P =0.000).Comparison of BIS between two groups showed difference was statistically significance (P =0.000).The area under the ROC of BIS was 0.943.When BIS ≤ 60,the sensitivity of predicting poor prognosis of patients after CPR was 100％ ; the specificity was 88％.Conclusions BIS monitoring could be a high sensitive indicator of evaluating prognosis of patients after cardiopulmonary resuscitation.