中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2009年
6期
361-363
,共3页
脑电双频指数%镇静躁动评分%机械通气%镇静深度%评估
腦電雙頻指數%鎮靜躁動評分%機械通氣%鎮靜深度%評估
뇌전쌍빈지수%진정조동평분%궤계통기%진정심도%평고
bispeetral index%sedation-agitation scale%mechanical ventilation%sedation depth%assess
目的 观察脑电双频指数(BIS)监测与主观评分的相关性,研究其对机械通气患者镇静深度评估的可行性.方法 将重症监护病房(ICU)需要机械通气的83例患者随机分为两组,设定镇静目标为镇静一躁动评分(SAS)3～4分,分别用BIS(研究组,42例)和SAS(对照组,41例)监测患者的镇静深度,记录两组患者镇静前及镇静后每隔16 h的呼吸、循环指标和BIS、SAS、Ramsay 3种镇静评分,比较组间差异,分析各种评分的相关性.结果 83例患者均达镇静目标,两组间呼吸、循环指标比较差异均无统计学意义(P均>0.05).所有患者镇静后呼吸频率、吸入氧浓度较镇静前显著下降,脉搏血氧饱和度显著升高,差异均有统计学意义(P均<0.05);BIS值与主观评分间相关性良好,其中BIS与SAS评分呈显著正相关(r=0.626,P<0.05),与Ramsay评分呈显著负相关(r=-0.650,P<0.05),SAS与Ramsay评分呈显著负相关(r=0.908,P<0.05).结论 用BIS监测评估机械通气患者镇静深度简单方便、同步有效,是评价ICU机械通气患者镇静深度的良好客观指标.
目的 觀察腦電雙頻指數(BIS)鑑測與主觀評分的相關性,研究其對機械通氣患者鎮靜深度評估的可行性.方法 將重癥鑑護病房(ICU)需要機械通氣的83例患者隨機分為兩組,設定鎮靜目標為鎮靜一躁動評分(SAS)3～4分,分彆用BIS(研究組,42例)和SAS(對照組,41例)鑑測患者的鎮靜深度,記錄兩組患者鎮靜前及鎮靜後每隔16 h的呼吸、循環指標和BIS、SAS、Ramsay 3種鎮靜評分,比較組間差異,分析各種評分的相關性.結果 83例患者均達鎮靜目標,兩組間呼吸、循環指標比較差異均無統計學意義(P均>0.05).所有患者鎮靜後呼吸頻率、吸入氧濃度較鎮靜前顯著下降,脈搏血氧飽和度顯著升高,差異均有統計學意義(P均<0.05);BIS值與主觀評分間相關性良好,其中BIS與SAS評分呈顯著正相關(r=0.626,P<0.05),與Ramsay評分呈顯著負相關(r=-0.650,P<0.05),SAS與Ramsay評分呈顯著負相關(r=0.908,P<0.05).結論 用BIS鑑測評估機械通氣患者鎮靜深度簡單方便、同步有效,是評價ICU機械通氣患者鎮靜深度的良好客觀指標.
목적 관찰뇌전쌍빈지수(BIS)감측여주관평분적상관성,연구기대궤계통기환자진정심도평고적가행성.방법 장중증감호병방(ICU)수요궤계통기적83례환자수궤분위량조,설정진정목표위진정일조동평분(SAS)3～4분,분별용BIS(연구조,42례)화SAS(대조조,41례)감측환자적진정심도,기록량조환자진정전급진정후매격16 h적호흡、순배지표화BIS、SAS、Ramsay 3충진정평분,비교조간차이,분석각충평분적상관성.결과 83례환자균체진정목표,량조간호흡、순배지표비교차이균무통계학의의(P균>0.05).소유환자진정후호흡빈솔、흡입양농도교진정전현저하강,맥박혈양포화도현저승고,차이균유통계학의의(P균<0.05);BIS치여주관평분간상관성량호,기중BIS여SAS평분정현저정상관(r=0.626,P<0.05),여Ramsay평분정현저부상관(r=-0.650,P<0.05),SAS여Ramsay평분정현저부상관(r=0.908,P<0.05).결론 용BIS감측평고궤계통기환자진정심도간단방편、동보유효,시평개ICU궤계통기환자진정심도적량호객관지표.
Objective To investigate the correlation between subjective scoring and bispectral index (BIS) monitoring, and to study the feasibility of BIS monitor in assessing the depth of sedation for mechanically ventilated patients. Methods A prospective randomized controlled trial was conducted. The sedation target was sedation-agitation scale (SAS) 3 - 4. A total of 83 patients in the intensive care unit were assigned to receive the sedation based on BIS monitor (42 eaese) or the sedation based on subjective scale SAS (41 eases). The parameters of respiration, circulation, and the depth of sedation (BIS, SAS, Ramsay) were recorded. The difference between the two groups was compared. The correlation index and significance were calculated. Results A total of 83 patients of two groups reached the sedation target. Statistically significant difference was found between two groups in respiratory rate, fraction of inspiratory oxygen, and pulse saturation of oxygen before and after sedation (all P<0.05). After sedation, respiratory rate and fraction of inspiratory oxygen declined in all patients, while pulse saturation of oxygen rose obviously (all P<0. 05). Statistically significant difference was also found in different correlation index. There was positive correlation index between BIS and SAS (r=0. 626, P<0. 05), a negative correlation index between BIS and Ramsay (r=-0. 650, P<0. 05), and also a negative correlation index between SAS and Ramsay (r=- 0. 908, P<0.05). Statistically significant difference was not found in the parameters of respiration and circulation between the two groups. Conclusion BIS monitor is feasible for assessing the depth of sedation in mechanically ventilated patients.
