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目的评价脑状态指数(cerebral state index,CSI)、肌电指数(electromyogmphic,EMG)、爆发抑制指数(burst suppression,BS)等指标在量化昏迷深度及监测脑功能损害程度中的作用。方法对50例临床脑损害昏迷患者进行脑状态监测(cerebral stale monitor,CSM),分析这些指标与患者的体征反射、听觉诱发电位(AEP)、格拉斯哥昏迷评分(GCS)及格拉斯哥预后评分(GOS)改变的关系。结果CSI 0～100是从清醒到深昏迷、脑死亡一个连续不断的刻度范围,与患者昏迷深度确切相关,与GCS、体征反射相应消涨；在恒定刺激作用下的CSI变化,结合BS、EMG能够准确判断患者预后,量化脑功能的改变并赋予其相应的临床意义。结论通过CSM获得量化的、数字化的脑功能损害程度,可以实时判定昏迷深度及昏迷动态演变过程,客观地指导临床救治和把握预后,根本改善了根据临床表现来评定所存在的明显的人为差异、缺少客观物证的昏迷及预后评分的现状。
Objective To evaluate the effects of cerebral state index (CSI), electromyogic (EMG) and burst suppression index (BS) on the quantitative coma depth and the degree of brain damage monitoring. Methods Fifty patients with clinical brain damage and coma were enrolled in this study. Cerebral status monitoring (CSM) was performed. The correlations of these parameters with those of patients with signs of symptoms, auditory evoked potential (AEP), Glasgow coma scale (GCS) and Glasgow prognostic score (GOS) Change the relationship. Results CSI 0-100 was a continuous scale of brain death from awake to deep coma. It was closely related to the coma depth of patients and corresponding to GCS. The change of CSI under constant stimulation combined with BS and EMG could Accurately determine the prognosis of patients, quantify changes in brain function and give their corresponding clinical significance. Conclusion The quantified and digitized damage of brain function obtained by CSM can judge the coma depth and coma dynamic evolution in real time, objectively guide the clinical treatment and grasp the prognosis, and fundamentally improve the obvious human differences assessed according to the clinical manifestations. The lack of objective evidence of coma and prognosis of the status quo.