[1]刘健伟,程矫,甄勇,等.术后早期脑电双频指数对高分级动脉瘤性蛛网膜下腔出血病人意识恢复的预测价值[J].中国临床神经外科杂志,2023,28(08):493-496.[doi:10.13798/j.issn.1009-153X.2023.08.005]
　LIU Jian-wei,CHENG Jiao,ZHEN Yong,et al.Value of early postoperative bispectral index in predicting consciousness recovery of patients with poor-grade aneurysmal subarachnoid hemorrhage[J].,2023,28(08):493-496.[doi:10.13798/j.issn.1009-153X.2023.08.005]
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术后早期脑电双频指数对高分级动脉瘤性蛛网膜下腔出血病人意识恢复的预测价值()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年08期
页码:
493-496
栏目:
论著
出版日期:
2023-08-31

文章信息/Info

Title:
Value of early postoperative bispectral index in predicting consciousness recovery of patients with poor-grade aneurysmal subarachnoid hemorrhage
文章编号:
1009-153X（2023）08-0493-04
作者:
刘健伟; 程矫; 甄勇; 何亮; 宋炳伟; 耿平; 胡建兵
225000江苏扬州，江苏省苏北人民医院急诊医学科（刘健伟、程矫、甄勇、耿平、胡建兵），神经外科（程矫、甄勇、何亮、宋炳伟）
Author(s):
LIU Jian-wei1;  CHENG Jiao2;  ZHEN Yong2;  HE Liang2;  SONG Bing-wei2;  GENG Ping1;  HU Jian-bing1
1. Department of Emergency, Northern Jiangsu People's Hospital, Yangzhou 225000, China; 2. Department of Neurosurgery, Northern Jiangsu People's Hospital, Yangzhou 225000, China
关键词:
高分级动脉瘤性蛛网膜下腔出血; 脑电双频指数; 意识恢复; 预测
Keywords:
Poor-grade aneurysmal subarachnoid hemorrhage;  Bispectral index;  Consciousness recovery
分类号:
A
DOI:
10.13798/j.issn.1009-153X.2023.08.005
文献标志码:
R 743.9
摘要:
目的 探讨术后早期脑电双频指数（BIS）对高分级（Hunt-Hess分级Ⅵ~Ⅴ级）动脉瘤性蛛网膜下腔出血（aSAH）病人术后意识恢复的预测价值。方法 选择2015年1月至2021年12月手术治疗的156例高分级aSAH，术后3 d记录BIS值，并计算BIS低值、高值、均值；术后随访6个月，根据GCS评分评估意识恢复情况，GCS评分≥13分判定为意识恢复。结果 156例中，术后6个月意识恢复76例；意识未恢复80例，其中昏迷45例，死亡35例。意识恢复组BIS低值、高值、均值较意识未恢复组均显著增高（P<0.01）。ROC曲线分析显示，BIS低值、高值、均值预测意识恢复的曲线下面积分别为0.758（95% CI 0.682~0.834）、0.866（95% CI 0.808~0.924）、0.830（95% CI 0.765~0.895）。BIS低值≥41预测意识恢复的敏感度为73.7%、特异度为67.5%，阳性预测值为68.3%，阴性预测值为73.0%；BIS高值≥55预测意识恢复的敏感度为92.1%、特异度为75.0%，阳性预测值为77.8%，阴性预测值为90.9%；BIS均值≥47预测意识恢复的敏感度为86.8%，特异度为73.8%，阳性预测值为75.9%，阴性预测值为85.5%。结论 BIS能客观地反映脑电活动，可以预测高分级aSAH术后意识恢复情况，其中BIS高值预测准确性最高。
Abstract:
Objective To investigate the value of early postoperative bispectral index (BIS) in predicting consciousness recovery of patients with poor-grade (Hunt-Hess grade Ⅵ~Ⅴ) aneurysmal subarachnoid hemorrhage (aSAH). Methods A total of 156 patients with poor-grade aSAH who underwent surgery were selected from January 2015 to December 2021. BIS values were recorded within 3 days after the operation, and the low, high and mean values of BIS were calculated. Six months after the operation, consciousness status was assessed according to GCS score, with a GCS score ≥13 as consciousness recovery. Results Of these 156 patients, 76 patients (recovery group) regained consciousness 6 months after the operation and 80 patients (no recovery group) did not (45 unconscious, 35 death). The low, high and mean values of BIS in the recovery group were significantly higher than those in the no recovery group (P<0.01). ROC curve analysis showed that the area under the curve of low, high and mean values of BIS for predicting consciousness recovery were 0.758 (95%CI 0.682~0.834), 0.866 (95%CI 0.808~0.924) and 0.830 (95%CI 0.765~0.895), respectively. For predicting consciousness recovery, the sensitivity and specificity of BIS low value ≥41 were respectively 73.7% and 67.5%, the positive and negtive predictive values were respectively 68.3% and 73.0%; the sensitivity and specificity of BIS high value ≥55 were respectively 92.1% and 75.0%, the positive and negtive predictive values were respectively 77.8% and 90.9%; the sensitivity and specificity of BIS mean value ≥47 were respectlvely 86.8% and 73.8%, the positive and negative predictive values were rspectively 75.9% and 85.5%. Conclusions BIS can objectively reflect the electrical activity of the brain, and can predict the recovery of consciousness of patients with poor-grade aSAH after the operation, and the prediction accuracy of BIS high value is the highest.

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备注/Memo

备注/Memo:
（2023-04-30收稿，2023-07-29修回）
基金项目：扬州市社会发展基金（YZ2021089）
通讯作者：宋炳伟，E-mail：1697124778@qq.com
更新日期/Last Update: 2022-08-31