脑电双频指数、颅多普勒与颅内压联合监测在重度颅脑损伤预后评估中的价值

doi:10.20047/j.issn1673-7210.2023.02.15

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摘要目的探究脑电双频指数（BIS）、颅多普勒（TCD）、颅内压（ICP）联合监测对重度颅脑损伤预后评估中的价值。方法选择江苏省宿迁市第一人民医院2018年11月至2021年11月收治的80例留置ICP的重度颅脑损伤患者，根据治疗21 d的格拉斯哥昏迷量表评分将其分为预后良好组（59例）和预后不良组（21例），收集并整理所有患者的基础资料及BIS、ICP、TCD[平均血流速度（Vm）]数据。采用logistic回归模型分析重度颅脑损伤患者预后不良的相关因素，采用受试者操作特征曲线（ROC）评估BIS、TCD与ICP联合监测在重度颅脑损伤预后评估中的价值。结果预后不良组ICP高于预后良好组，BIS、Vm低于预后良好组（P＜0.05）。多因素分析结果显示，BIS、ICP、Vm水平为重度颅脑损伤患者预后不良的影响因素（P＜0.05）。BIS、Vm与ICP联合预测重度颅脑损伤预后的曲线下面积高于各项单独预测（P＜0.05）。结论 BIS、TCD与ICP联合监测在重度颅脑损伤患者预后评估中具有较高的价值，值得临床重点关注。

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	丁丽丽刘梦茹孙海军▲

关键词 ：脑电双频指数, 颅多普勒, 颅内压, 重度颅脑损伤

Abstract：Objective To explore the value of combined monitoring of bispectral index (BIS), transcranial Doppler (TCD), and intracranial pressure (ICP) in prognosis assessment of severe craniocerebral injury. Methods A total of 80 patients with ICP with severe craniocerebral injury admitted to the First People’s Hospital of Suqian, Jiangsu Province from November 2018 to November 2021 were selected and divided into good prognosis group (59 cases) and poor prognosis group (21 cases) according to the Glasgow coma scale score 21 days after treatment. Basic data, BIS, ICP, and TCD data (mean blood flow velocity [Vm]) of all patients were collected, and sorted out. Logistic regression model was used to analyze the related factors of poor prognosis in patients with severe craniocerebral injury, and receiver operating characteristic curve (ROC) was used to evaluate the value of combined monitoring of BIS, TCD, and ICP in the prognosis assessment of severe craniocerebral injury. Results ICP in the poor prognosis group were higher than those in the good prognosis group, BIS, and Vm were lower than those in the good prognosis group (P＜0.05). The results of multivariate analysis showed that BIS, ICP, and Vm were influencing factors for poor prognosis of patients with severe craniocerebral injury (P＜0.05). The area under the curve of BIS, Vm, and ICP combined predicted the prognosis of severe craniocerebral injury was higher than that of each prediction alone (P＜0.05). Conclusion The combined monitoring of BIS, TCD, and ICP has a high value in the prognosis assessment of patients with severe craniocerebral injury, and worthy of clinicall attention.

Key words： Bispectral index Transcranial Doppler Intracranial pressure Severe craniocerebral injury

基金资助:江苏省自然科学基金面上项目（BK20181152）。

通讯作者: ▲通讯作者

作者简介: 丁丽丽（1986.2-），女，硕士，主要从事急危重病等治疗工作。

引用本文:

丁丽丽刘梦茹孙海军▲. 脑电双频指数、颅多普勒与颅内压联合监测在重度颅脑损伤预后评估中的价值[J]. 中国医药导报, 2023, 20(2): 69-71,79.
DING Lili LIU Mengru SUN Haijun▲. Value of combined monitoring of bispectral index, transcranial Doppler, and intracranial pressure in prognosis assessment of severe craniocerebral injury. 中国医药导报, 2023, 20(2): 69-71,79.

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https://www.yiyaodaobao.com.cn/CN/10.20047/j.issn1673-7210.2023.02.15 或 https://www.yiyaodaobao.com.cn/CN/Y2023/V20/I2/69