中国现代医药杂志
中國現代醫藥雜誌
중국현대의약잡지
MODERN MEDICINE JOURNAL OF CHINA
2014年
7期
21-24
,共4页
脑电双频指数%RASS评分%右美托咪定%丙泊酚%镇静
腦電雙頻指數%RASS評分%右美託咪定%丙泊酚%鎮靜
뇌전쌍빈지수%RASS평분%우미탁미정%병박분%진정
Bispectral index%Richmond Agitation-Sedation%Scale Dexmedetomidin%Propofol Sedation
目的：比较脑电双频指数监测右美托咪定及丙泊酚镇静深度的准确性。方法需要机械通气的重症患者40例，随机分为右美托咪定组（D组）和丙泊酚组（P组），各20例。右美托咪定组（D 组）给予负荷剂量1μg/kg，维持剂量0.2～0.7μg·kg-1·min-1。丙泊酚组（P组）给予负荷剂量1～3mg/kg，维持剂量0.5～4.0mg·kg-1·min-1镇静。机械通气后24h内，两组患者均每2h记录一次BIS值，随后立即进行RASS评分；同时记录两组患者镇静前后的心率（HR）、呼吸频率（RR）、平均动脉压（MAP）、经皮血氧饱和度（SpO2）。以RASS评分＜-3分为标准绘制受试者工作特征曲线（ROC 曲线），确定两组药物镇静适度时所对应的最适BIS 值。结果两组患者BIS与RASS评分均具有较好相关性,其中右美托咪定组的相关性较丙泊酚组差。右美托咪定组患者的最佳BIS截断值为58.5，灵敏度、特异度分别为0.929、0.872；丙泊酚组患者的最佳BIS截断值为63.5，灵敏度、特异度分别为0.987、0.875。两组患者镇静后的生命体征均较镇静前平稳。结论 BIS 可用于监测右美托咪定的镇静深度，但准确性较其监测丙泊酚的镇静深度差，在相同等级的RASS评分下，应用右美托咪定镇静的BIS值偏低。
目的：比較腦電雙頻指數鑑測右美託咪定及丙泊酚鎮靜深度的準確性。方法需要機械通氣的重癥患者40例，隨機分為右美託咪定組（D組）和丙泊酚組（P組），各20例。右美託咪定組（D 組）給予負荷劑量1μg/kg，維持劑量0.2～0.7μg·kg-1·min-1。丙泊酚組（P組）給予負荷劑量1～3mg/kg，維持劑量0.5～4.0mg·kg-1·min-1鎮靜。機械通氣後24h內，兩組患者均每2h記錄一次BIS值，隨後立即進行RASS評分；同時記錄兩組患者鎮靜前後的心率（HR）、呼吸頻率（RR）、平均動脈壓（MAP）、經皮血氧飽和度（SpO2）。以RASS評分＜-3分為標準繪製受試者工作特徵麯線（ROC 麯線），確定兩組藥物鎮靜適度時所對應的最適BIS 值。結果兩組患者BIS與RASS評分均具有較好相關性,其中右美託咪定組的相關性較丙泊酚組差。右美託咪定組患者的最佳BIS截斷值為58.5，靈敏度、特異度分彆為0.929、0.872；丙泊酚組患者的最佳BIS截斷值為63.5，靈敏度、特異度分彆為0.987、0.875。兩組患者鎮靜後的生命體徵均較鎮靜前平穩。結論 BIS 可用于鑑測右美託咪定的鎮靜深度，但準確性較其鑑測丙泊酚的鎮靜深度差，在相同等級的RASS評分下，應用右美託咪定鎮靜的BIS值偏低。
목적：비교뇌전쌍빈지수감측우미탁미정급병박분진정심도적준학성。방법수요궤계통기적중증환자40례，수궤분위우미탁미정조（D조）화병박분조（P조），각20례。우미탁미정조（D 조）급여부하제량1μg/kg，유지제량0.2～0.7μg·kg-1·min-1。병박분조（P조）급여부하제량1～3mg/kg，유지제량0.5～4.0mg·kg-1·min-1진정。궤계통기후24h내，량조환자균매2h기록일차BIS치，수후립즉진행RASS평분；동시기록량조환자진정전후적심솔（HR）、호흡빈솔（RR）、평균동맥압（MAP）、경피혈양포화도（SpO2）。이RASS평분＜-3분위표준회제수시자공작특정곡선（ROC 곡선），학정량조약물진정괄도시소대응적최괄BIS 치。결과량조환자BIS여RASS평분균구유교호상관성,기중우미탁미정조적상관성교병박분조차。우미탁미정조환자적최가BIS절단치위58.5，령민도、특이도분별위0.929、0.872；병박분조환자적최가BIS절단치위63.5，령민도、특이도분별위0.987、0.875。량조환자진정후적생명체정균교진정전평은。결론 BIS 가용우감측우미탁미정적진정심도，단준학성교기감측병박분적진정심도차，재상동등급적RASS평분하，응용우미탁미정진정적BIS치편저。
Objective To compare the accuracy of the application of bispectral index (BIS) on dexmedetomidin and propofol in monitoring sedation depth. Methods 40 patients needing mechanical ventilation in ICU were selected in the study. The patients were randomly divided into two groups: group D(n=20):dexmedetomidine group; group P(n=20): propofol group. Group D:the loading dose of dexmedetomidine was 1μg/kg,and the maintained dose was 0.2~0.7μg·kg-1·min-1. Group P: the loading dose of propofol was 1~3mg/kg,and the maintained dose was 0.5~4.0mg·kg-1·min-1. Mechanical ventilation in 24 hours, the BIS of each patient was measured every 2 hours and RASS was scored at once. Meanwhile, heart rate(HR), respiration rate (RR), mean arterial pressure(MAP) and saturation of peripheral oxygen(SpO2) was monitored respectively. Receiver operating characteristic (ROC) curve was drawn with the standard whose RASS was lower than-3 point in order to determine the optimal BIS value when adequate sedation level were achieved in the two groups respectively. Results The BIS and RASS of the two groups had positive correlation, but dexmedetomidine group was poorer than that in propofol group. The optimal cutoff BIS value was 58.5(sensitivity was 0.929, specificity was 0.872)for dexmedetomidin and 63.5(sensitivity was 0.987,specificity was 0.875) for propofol. The vital signs in two groups were more stable after sedation than before. Conclusion BIS could be an effective monitor of the sedation with dexmedetomidin, but less accurate than propofol. The BIS value with dexmedetomidin is lower than with propofol at the same level of RASS.
