格拉斯哥昏迷量表评分和全面无反应性量表评分与脑电双频指数及呼吸机相关性肺炎的相关性研究

发布时间：2018-01-19 08:10

  本文关键词： 肺炎 呼吸机相关性 意识障碍 格拉斯哥昏迷量表 全面无反应性量表　出处：《中国全科医学》2017年27期 　论文类型：期刊论文

【摘要】：目的探讨格拉斯哥昏迷量表(GCS)评分和全面无反应性量表(FOUR)评分与脑电双频指数(BIS)及呼吸机相关性肺炎(VAP)的相关性,旨在为临床预防VAP提供帮助。方法选取2015年7—12月天津市第一中心医院ICU收治的建立人工气道并进行机械通气的患者40例作为研究对象。患者进入ICU 12 h内进行GCS、FOUR评分,同时行24 h BIS监测,记录相关数值,采用国内标准或临床肺部感染积分(CPIS积分)诊断VAP,并追踪患者VAP发生情况。GCS、FOUR评分与BIS及VAP的相关性分别采用Pearson相关分析、Spearman秩相关分析。结果GCS评分为(8.3±4.0)分,FOUR评分为(8.3±3.7)分,BIS为(69.7±17.6)。GCS、FOUR评分均与BIS呈正相关(r值分别为0.761、0.821,P0.01)。GCS评分与早发性VAP无直线相关关系(r_s=0.885,P0.05);GCS评分与晚发性VAP呈高度负相关(r_s=-0.994,P0.01)。FOUR评分与早发性VAP呈高度正相关(r=0.992,P0.01);GCS评分与晚发性VAP呈高度负相关(r_s=-0.958,P0.05)。结论与GCS评分相比,FOUR评分与BIS、VAP的相关性更高,推测FOUR评分更适合用于评估患者的意识障碍程度和预测VAP的发生,且其具有使用简便、便于记忆等优势。
[Abstract]:Objective to investigate the correlation between Glasgow coma scale (Glasgow coma scale) and total non-reactivity scale (FOURL) with bispectral index (BIS) and ventilator associated pneumonia (VAP). Methods 40 patients with artificial airway and mechanical ventilation admitted to ICU of Tianjin first Central Hospital from July to December in 2015 were selected as study objects. Patients entering ICU. GCS was performed within 12 hours. At the same time, the FOUR score was monitored for 24 hours, and the relevant values were recorded. VAP was diagnosed by domestic standard or clinical pulmonary infection score. The correlation between the incidence of VAP and BIS and VAP was analyzed by Pearson. Results the GCS score was 8.3 卤4.0 and the Four score was 8.3 卤3.7. The BIS score was 69.7 卤17.6 卤17.6. the Four score was positively correlated with BIS, and the r value was 0.761 卤0.821, respectively. There was no linear correlation between P0.01GCS score and early onset VAP. There was a highly negative correlation between GCS score and late VAP. There was a high positive correlation between the score of GCS and the score of early onset VAP. P0.01; There was a high negative correlation between GCS score and late VAP. Conclusion compared with GCS score, the correlation between GCS score and BIS VAP is higher. It is suggested that FOUR score is more suitable for evaluating the degree of consciousness disorder and predicting the occurrence of VAP, and it has the advantages of simple use and convenient memory.
【作者单位】： 天津中医药大学研究生院;天津市第一中心医院;
【基金】：天津市卫生行业重点攻关项目(14KG101) 天津市卫生局科技基金项目(2012KZ027)
【分类号】：R459.7
【正文快照】： 意识障碍评分量表是对意识障碍患者进行定量评估WIJDICKS等[3]针对GCS缺陷设计的用于评估意识障碍的临床工具,具有临床指征量化、简便易行、重复性好程度的新量表,包括睁眼反应、运动反应、脑干反射、等优势。格拉斯哥昏迷量表(GCS)是由TEASDALE呼吸节律4个计分项目。每个计分，

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