摘要
目的探讨早期脑电双频指数（bispectralindex，BIS）监测对脓毒症相关性脑病（sepsis-associatedencephalopathy，SAE）患者诊断、病情严重程度的评估价值。方法回顾性分析ICU收治的脓毒症患者80例，根据是否出现中枢神经系统障碍分为脑病组（试验组）和非脑病组（对照组）。所有患者均在入住ICU后进行标准脓毒症复苏治疗流程（按脓毒症治疗指南2012）。入ICU后立即行BIS持续监测24h取其均值，同时记录格拉斯哥昏迷评分（GCS）、急性生理与慢性健康状况评分Ⅱ（APACHEⅡ），并抽血检测降钙素原（PCT）、S-100B蛋白。对两组患者24h的BIS平均值、PCT、S-100B蛋白、GCS评分、APACHEII评分进行组内及组间比较，并进行相关性分析。结果①脑病组与非脑病组的BIS值、PCT、S-100B蛋白、GCS评分、APACHEⅡ评分比较差异有统计学意义（P〈0．01）。②BIS值与GCS、APACHEII评分呈明显正相关（P〈0．01）。结论持续BIS监测可评估脓毒症患者脑损伤的严重程度，并做出早期诊断。
Objective To investigate the continuous bispectral index （BIS） monitoring for the early diagnosis, disease severity evaluation in patients with sepsis encephalopathy. Methods This retrospective analysis contained 80 patients with sepsis admitted in our department, and these patients were divided into encephalopathy group （ experimental group） and non - encephalopathy group （ control group）. After ICU admission, all the patients received standard sepsis recovery treatment （sepsis treatment guide 2012）. Immediately after ICU admission, they were continuously monitored the BIS for 24 h in order to get a 24 - h - average ; at the same time, the Glasgow coma scale （GCS） and acute physiology and chronic health evaluation Ⅱ （ APACHE Ⅱ ） were recorded, and blood samples were taken for the detection of serum PCT and S - 100B protein content. The average BIS values, PCT, S - 100B protein, GCS score and APACHE Ⅱ score were compared between the groups, and correlation analysis was also done between the groups. Results （1）When compared the eneephalopathy group and non - eneephalopathy group, the BIS, PCT, S - 100B protein, GCS score and APACHE Ⅱ score had significant difference（P 〈0.01 ）. （2）The BIS value was positively correlated with GCS, APACHE Ⅱ score significantly （P 〈 0.01 ）. Conclusion Continuous BIS monitoring can evaluate sepsis severity in patients with brain injury, and to make an early diagnosis.
出处
《中国急救医学》
CAS
CSCD
北大核心
2015年第11期982-985,共4页
Chinese Journal of Critical Care Medicine
