目的 分析脑电双频谱指数（BIS）动态变化对老年原发性肝癌腹腔镜术后低血压的预测价值。 方法 选择2021年11月至2024年7月医院收治的197例拟进行腹腔镜手术治疗的老年原发性肝癌患者作为研究对象，所有患者均行全身麻醉，同时监测患者围手术期的BIS。根据患者腹腔镜术后低血压的发生情况将其分为低血压组和无低血压组，比较两组一般资料及麻醉诱导前5 min（T0）、麻醉诱导后5 min（T1）、手术开始后30 min（T2）、手术结束时（T3）的BIS。采用logistic回归分析老年原发性肝癌腹腔镜术后低血压的影响因素，另采用受试者工作特征（ROC）曲线分析BIS对老年原发性肝癌腹腔镜术后低血压的预测价值。 结果 197例老年原发性肺癌患者中有51例患者腹腔镜术后出现低血压，发生率为25.89%。低血压组的高血压占比、手术时间均高于无低血压组（P < 0.05），白蛋白（ALB）水平及T2时BIS、T3时BIS均低于无高血压组（P < 0.05）。logistic回归分析显示，高血压、手术时间长、低ALB水平、T2时低BIS值、T3时低BIS值均为老年原发性肝癌腹腔镜术后低血压的危险因素（P < 0.05）。T2和T3时BIS联合预测老年原发性肝癌腹腔镜术后低血压的灵敏度、特异度、曲线下面积（AUC）分别为92.16%、78.08%、0.902，其中灵敏度和AUC高于单独预测（P < 0.05），特异度与单独预测相近。 结论 手术开始后30 min和手术结束时的BIS对老年原发性肝癌腹腔镜术后低血压的预测价值良好，且二者联合预测能进一步提高预测价值。

Objective To analyze the predictive value of bispectral index （BIS） dynamic changes for hypotension after laparoscopic surgery in elderly patients with primary liver cancer. Methods 197 elderly patients with primary liver cancer who underwent laparoscopic surgery in the hospital from November 2021 to July 2024 were selected as the research subjects， and all patients received general anesthesia， and their perioperative BIS was monitored. The patients were divided into a hypotension group and a non hypotension group based on the occurrence of hypotension after laparoscopic surgery. The general information and the BIS at 5 minutes before anesthesia induction （T0）， 5 minutes after anesthesia induction （T1）， 30 minutes after the start of surgery （T2） and the end of surgery （T3） in the two groups were compared. The influencing factors of hypotension after laparoscopic surgery in elderly patients with primary liver cancer were analyzed through Logistic regression analysis， and the predictive value of BIS for hypotension after laparoscopic surgery in elderly patients with primary liver cancer were analyzed through receiver operating characteristic （ROC） curve. Results 51 patients were experienced hypotension after laparoscopic surgery among 197 elderly patients with primary lung cancer， and the incidence rate was 25.89%. The proportion of hypertension and operative time in the hypotension group were higher than those in the non hypotension group （P < 0.05）， while the levels of albumin （ALB） and BIS at T2 and T3 were lower than those in the non hypertension group （P < 0.05）. logistic regression analysis showed that hypertension， long operative time， low ALB level， low BIS value at T2 and low BIS value at T3 were all risk factors for hypotension after laparoscopic surgery in elderly patients with primary liver cancer （P < 0.05）. The sensitivity， specificity and area under curve （AUC） of BIS combined prediction of hypotension after laparoscopic surgery in elderly patients with primary liver cancer at T2 and T3 were 92.16%， 78.08% and 0.902% respectively， and the sensitivity and AUC were higher than those single prediction （P < 0.05）， but the specificity was similar to that of single prediction. Conclusion The predictive value of BIS at 30 minutes after the start of surgery and the end of surgery for hypotension after laparoscopic surgery in elderly patients with primary liver cancer are good， and the joint prediction of this two can further enhance the predictive value.