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目的探索通过脑状态监测仪(cerebral state monitor,CSM)获取患者数字化处理的脑电(EEG)信号:脑电指数(脑状态指数cerebral state index, CSI)、肌电指数 (electromyographic,EMG)、爆发抑制指数(burst suppression,BS),量化昏迷深度及脑功能损害程度。方法对50例临床脑损害昏迷患者进行CSM监测,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、脑死亡的一个连续不断的刻度范围,与患者昏迷深度确切相关,与GCS 昏迷评分、体征反射相应消涨;特别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无创实时监测获得量化的、数字化的脑功能损害程度,可以建立起量化的、数字化的脑功能损害临床标准,客观地指导临床救治和把握预后。
Objective To explore the digital signals of electroencephalogram (EEG) digitized by cerebral state monitor (CSM): EEG (CSI), electromyographic (EMG) Burst suppression (BS), quantified coma depth and degree of brain damage. Methods CSM was monitored in 50 patients with clinical brain damage coma, and the relationship between these indexes and the signs of the patient, auditory evoked potential (AEP), Glasgow coma score (GCS) and Glasgow prognostic score (GOS) were analyzed. Results CSI 0 ~ 100 was a continuous scale of brain death from awake to deep coma, which was closely related to the coma depth of patients and correspondingly decreased with GCS coma score and signs of reflex. The changes of CSI, especially under constant stimulation, combined with BS, EMG can accurately determine the prognosis of patients, quantify changes in brain function and give their corresponding clinical significance. Conclusion The quantitative and digital brain damage can be quantified and quantified by CSM non-invasive real-time monitoring, which can objectively guide the clinical treatment and grasp the prognosis.