CAJ | 학술논문

目的评价和分析脑电双频指数(bispectral index,BIS)与舒适行为最表(COMFORT behavior scale,COMFORT B)相关性,探讨运用BIS评估6个月～2岁先天性心脏病患儿术后镇静程度的意义.方法采用前瞻性研究方法选择50例先天性心脏病术后接受镇静治疗的患儿.两位研究者在预定的监测时间点同步、独立记录BIS值和使用COMFORTB量表评估患儿镇静程度,共获得375例次观察数据.运用Spearman等级相关和预测概率分析BIS与COMFORT B量表之间的相关性,判断BIS预测不同镇静程度的准确性.结果 COMFORT B量表评分各等级(镇静过度、镇静适度和镇静不足)对应的BIS值分别为57.0±11.0、69.9±7.6和84.4±9.0.BIS值与COMFORT B量表等级评分呈中度相关(rs =0.63,P＜0.0001).其中6个月～1岁组rs为0.66,1～2岁组rs为0.59(P均＜0.0001).反映BIS能够正确预测不同镇静程度的预测概率值为0.85(P ＜0.0001).结论 BIS是一项能准确、有效监测6个月～2岁先天性心脏病患儿术后镇静程度的客观指标.
목적 평개화분석뇌전쌍빈지수(bispectral index,BIS)여서괄행위최표(COMFORT behavior scale,COMFORT B)상관성,탐토운용BIS평고6개월～2세선천성심장병환인술후진정정도적의의.방법 채용전첨성연구방법선택50례선천성심장병술후접수진정치료적환인.량위연구자재예정적감측시간점동보、독립기록BIS치화사용COMFORTB량표평고환인진정정도,공획득375례차관찰수거.운용Spearman등급상관화예측개솔분석BIS여COMFORT B량표지간적상관성,판단BIS예측불동진정정도적준학성.결과 COMFORT B량표평분각등급(진정과도、진정괄도화진정불족)대응적BIS치분별위57.0±11.0、69.9±7.6화84.4±9.0.BIS치여COMFORT B량표등급평분정중도상관(rs =0.63,P＜0.0001).기중6개월～1세조rs위0.66,1～2세조rs위0.59(P균＜0.0001).반영BIS능구정학예측불동진정정도적예측개솔치위0.85(P ＜0.0001).결론 BIS시일항능준학、유효감측6개월～2세선천성심장병환인술후진정정도적객관지표.
Objective To evaluate and analyze the degree of correlation between the bispectral index (BIS) and COMFORT behavior scale (COMFORT B scale) and to explore the usability of BIS in assessing the level of sedation for young infants from 6 months to 2 years old after surgical repairs of congenital heart disease.Methods A prospective observational study was designed to involve 50 young infants to assess their postoperative sedation depth.Two investigators evaluated the level of sedation simultaneously and independently by using BIS and COMFORT B scale at each fixed observational points.A total of 375 data sets were gathered by observations.Correlations between BIS value and COMFORT B scale were determined by using Spearman rank correlation test and prediction probability to evaluate the accuracy of the performance of BIS on various sedation depths.Results BIS values in correspondence with different level of sedation,which was divided into oversedation,adequate sedation,undersedation according to COMFORT B scale,were 57.0 ±11.0,69.9 ± 7.6 and 84.4 ± 9.0.There was a moderate correlation between BIS values aad COMFORT B scale ( rs =0.63,P ＜0.000 1 ).The Spearman correlation between BIS and COMFORT B was rs =0.66 and rs =0.59 for the age groups 6 months ～ 1 year old and 1 ～ 2 years old,respectively ( P ＜0.000 1 ).Prediction probability value which indicated BIS can correctly predict various levels of sedation was 0.85 ( P ＜0.000 1 ).Contusion BIS is an accurate and valid objective parameter to assess the level of sedation for young infants from 6 months to 2 years old.