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

doi:10.3969/j.issn.1006-6233.2018.01.017

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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.

Key words： Narcotrend index Coma Disturbance of consciousness Prognosis

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2018.01.017 OR http://www.hbyxzzs.cn/EN/Y2018/V24/I1/69

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