Abstract：Objective: To explore the quantitative assessment and prognostic value of the Narcotrend index for the degree of disturbance of consciousness in coma patients. Methods: 42 severe comatose patients admitted to our department of critical care medicine from January 2016 to February 2017 were selected. The correlation between NT and APACHE II and GCS score before and after stimulation, the correlation between NT and GOS score before and after stimulation, and prognosis of NT before and after stimulation were analyzed. Results: The NT value of the patients was (56.62 ± 25.59), GCS was (4.55 ± 0.80), APACHE II was (28.57 ± 7.46), and there was a positive correlation between NT and GCS before stimulation (correlation coefficient r = 0.881, P <0.001). The NT value of the patients was (61.72 ± 29.87), the GOS was (2.43 ± 1.35), and the NT and GOS scores before and after stimulation were significantly correlated with APACHE II (correlation coefficient r=0.-952, P <0.001, r=0.905, P<0.001).The area under the curve of NT before stimulation was 0.916, 95% confidence interval was 0.833~ 0.999, and coma patients were predicted The optimal cut-off rate was 59.67, the sensitivity was 92.9%, the specificity was 71.4%, the missed diagnosis rate was 7.1%, the misdiagnosis rate was 28.6%, and the area under the curve of NT value after stimulation was 0.957, 95% The optimal cut-off rate was 74.58, the sensitivity was 97.3%, the specificity was 92.9%, the misdiagnosis rate was 2.7%, the misdiagnosis rate was 7.1%, and the NT value of the patients before and after stimulation was 74.58. The area under the good prognosis curve of the coma patients was 0.916, 0.957> 0.9, the NT value predicted the good prognosis of coma patients Correctness higher. Conclusion: The Narcotrend index of coma patients is significantly correlated with GCS and APACHE II scores, and it can be used to evaluate the prognosis of coma patients. In particular, the NT value of coma patients is better than that before stimulation. The prognosis, sensitivity, specificity are improved, missed diagnosis rate and misdiagnosis rate decreased.
钟映玉, 陈宇冲, 潘挺军, 黄寿新, 肖百芳, 罗文滔. Narcotrend指数对昏迷患者意识障碍程度的量化评定及预后评估价值研究[J]. 河北医学, 2018, 24(1): 69-73.
ZHAONG Yingyu, CHEN Yuchong, PAN Tingjun, et al. Quantitative Evaluation of the Degree of Consciousness Disorder in Coma patients and the Value of Prognostic Evaluation by Narcotrend Index. HeBei Med, 2018, 24(1): 69-73.
[1] Jung JY,Cho CB,Min BM.Bispectral index monitoring correlates with the level of consciousness in brain injured patients[J].Korean Anesthesiol,2013,64(3):246~250. [2] 康茵,邓龙姣,赵国栋,等.Narcotrend监测不同麻醉深度对老年肠癌患者术后早期认知功能障碍的影响[J].临床麻醉学杂志,2013,29(8):734~737. [3] Sessler DI,Sigl JC,Kelley SD,et al.Hospital stay and mortality are increased in patients having a "triple low" of low blood pressure,low bispectral index, and low minimum alveolar concentration of volatile anesthesia[J].Anesthesiology,2012,116(2)1195~1203. [4] Gupta M,Shri I,Sakia P,et al.Comparison of equi-minimum alveolar concentration of sevoflurane and isoflurane on bispectral index values during both wash in and wash out phases:A prospective randomised study[J].Indian Anaesth,2015,59(2):79~84. [5] 黄凯清,陈祯,邓琅辉,等.Narcotrnd监测下不同麻醉导方法对高龄结肠癌手术患者血压与心率的影响[J].广东医学,2013,34(3):433~435. [6] 孙传江,古妙宁,徐建设.Narcotrend监测在七氟醚-舒芬太尼腹部手术麻醉苏醒期的应用[J].南方医科大学学报,2016,30(6):1379~1381. [7] Panousis P,Heller AR,Burghardt M,et al.The effects of electromyographic activity on the accuracy of the Narcotrend monitor compared with the Bispectral Index during combined anaesthesia[J].Anaesthesia,2014,62(9):868~874. [8] Rasmussen LS,Johnson T,Kuipers HM,et al.Does anaesthesia cause postoperative cognitive dysfunction A randomised study of regional versus general anaesthesia in 438 elderly patients[J].Act Anaesthesiol Scand,2013,47(3):260~266. [9] Lindholm ML,Traff S,Granath F,et al.Mortality within 2 years after surgery in relation to low intraoperative bispectral index values and preexisting malignant disease[J].Anesth Analg,2014,108(2):508~512. [10] Kertai MD,Pal N,Palanca BJ,et al.Association of perioperative risk factors and cumulative duration of low bispectral index with intermediate-term mortality after cardiac surgery in the B-Unaware Trial[J].Anesthesiology,2016,112(5):1116~1127. [11] Otto KA,Cebotari S,Hoffler HK,et al. Electroencephalographic Narcotrend index, spectral edge frequency and median power frequency as guide to anaesthetic depth for cardiac surgery in laboratory sheep[J].2012,191(3):354~359. [12] 周丽娜,邵彩霞,王素芳.Narcotrend 对重度颅脑损伤患者昏迷程度及预后评估价值的研究探讨[J].中国现代药物应用,2016,10(15):277~279.
2018, Vol. 24 
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