摘要：

目的: 探讨脑电双频指数（BIS）与自发性脑出血患者预后的相关性。方法: 纳入2019年3月至2022年5月在天津市环湖医院手术治疗的64例自发性脑出血患者，术后均转入重症监护病房。采用Glasgow昏迷量表（GCS）、快速序贯器官衰竭评分（qSOFA）、急性生理学和慢性健康状况评估Ⅱ（APACHEⅡ）及颅内压（ICP）监测评价疾病严重程度，记录术后人工呼吸道建立、有创性机械通气、颅内感染、肺部感染发生率，同时予持续脑电双频指数监测；采用Glasgow预后分级（GOS）和改良Rankin量表（mRS）评价预后，并记录住院时间。结果: 根据首次BIS值分为高BIS组（BIS值≥ 60，30例）和低BIS组（BIS值< 60，34例）。高BIS组GCS评分（t = 9.597，P = 0.000）、人工呼吸道建立（χ² = 12.818，P = 0.000）和有创性机械通气（χ² = 4.099，P = 0.043）比例、GOS评分（t = 13.964，P = 0.000）高于低BIS组，而qSOFA评分（t = - 2.033，P = 0.000）、APACHEⅡ评分（t = - 7.426，P = 0.000）、ICP值（t = - 6.643，P = 0.000）、mRS评分（t = 4.099，P = 0.000）低于低BIS组。相关分析结果显示，自发性脑出血手术后BIS值与GCS评分（r = 0.704，P = 0.000）和GOS评分（r = 0.633，P = 0.000）呈正相关，与ICP值（r = - 0.668，P = 0.000）、qSOFA评分（r = - 0.282，P = 0.025）、APACHEⅡ评分（r = - 0.646，P = 0.000）和mRS评分（r = - 0.508，P = 0.000）呈负相关。结论: 脑电双频指数监测对自发性脑出血手术后患者预后评价具有良好应用价值。

关键词: 脑出血, 脑电描记术, 颅内压, 预后

Abstract:

Objective: To evaluate the correlation between bispectral index (BIS) and the prognosis of patients with spontaneous intracerebral hemorrhage (sICH). Methods: Sixty - four patients with sICH admitted to intensive care unit after surgery in Tianjin Huanhu Hospital from March 2019 to May 2022 were enrolled. Glasgow Coma Scale (GCS), quick Sequential Organ Failure Assessment (qSOFA), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) and intracranial pressure (ICP) monitoring were used to evaluate the severity of disease. The incidence of postoperative artificial airway establishment, invasive mechanical ventilation, intracranial infection and pulmonary infection were recorded. At the same time, continuous BIS monitoring was performed. The Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) were used to evaluate the prognosis, and the length of hospital stay was recorded. Results: According to the first BIS value, the patients were divided into a high BIS group (BIS value ≥ 60, n = 30) and low BIS group (BIS value < 60, n = 34). In the high BIS group, GCS score (t = 9.597, P = 0.000), the proportion of artificial airway establishment (χ² = 12.818, P = 0.000) and invasive mechanical ventilation (χ² = 4.099, P = 0.043), and GOS score (t = 13.964, P = 0.000) were higher than those in the low BIS group, while qSOFA score (t = - 2.033, P = 0.000), APACHE Ⅱ score (t = - 7.426, P = 0.000), ICP value (t = - 6.643, P = 0.000) and mRS score (t = 4.099, P = 0.000) were lower than those in the low BIS group. Correlation analysis showed that BIS value was positively correlated with GCS score (r = 0.704, P = 0.000) and GOS score (r = 0.633, P = 0.000), and was negatively correlated with ICP value (r =- 0.668, P = 0.000), qSOFA score (r = - 0.282, P = 0.025), APACHEⅡ score (r = - 0.646, P = 0.000) and mRS score (r = - 0.508, P = 0.000) for patients with sICH after surgery. Conclusions: BIS monitoring has good application value in evaluating the prognosis of patients with sICH after surgery.

Key words: Cerebral hemorrhage, Electroencephalography, Intracranial pressure, Prognosis