CAJ | 학술논문

目的探讨 Narcotrend 脑电监测在休克早期患者麻醉中的应用价值。方法选择休克早期的患者16例，ASA Ⅲ~Ⅳ级。随机分Narcotrend 脑电监测组（A 组）和对照组（B 组）。A 组以 Narcotrend 监测结果判断麻醉深度并调节麻醉用药，使 Narcotrend 指数(NI)维持在 D0~D2水平；B 组由同一麻醉医师根据临床经验调节麻醉用药。记录诱导和术中的脑电分级情况和诱导及术中的 BP、HR、SpO2等生命体征，记录患者术毕的清醒时间、能被拔管情况及病死率。结果 A 组诱导麻醉深度在预设目标水平 D2~E1的比例明显高于 B 组（P ＜0.05）；A 组术中麻醉深度在预设目标水平 D0~D2的比例亦明显高于 B 组（P ＜0.05）；与 B 组比较，A 组诱导、术中的生命体征中 BP、HR 等更平稳（P ＜0.05）；术毕清醒并可拔除气管导管的例数更多（P ＜0.05），病死率更低。结论在休克早期患者中应用Narcotrend 脑电监测指导麻醉，有助于提高患者抢救的成功率。
목적탐토 Narcotrend 뇌전감측재휴극조기환자마취중적응용개치。방법선택휴극조기적환자16례，ASA Ⅲ~Ⅳ급。수궤분Narcotrend 뇌전감측조（A 조）화대조조（B 조）。A 조이 Narcotrend 감측결과판단마취심도병조절마취용약，사 Narcotrend 지수(NI)유지재 D0~D2수평；B 조유동일마취의사근거림상경험조절마취용약。기록유도화술중적뇌전분급정황화유도급술중적 BP、HR、SpO2등생명체정，기록환자술필적청성시간、능피발관정황급병사솔。결과 A 조유도마취심도재예설목표수평 D2~E1적비례명현고우 B 조（P ＜0.05）；A 조술중마취심도재예설목표수평 D0~D2적비례역명현고우 B 조（P ＜0.05）；여 B 조비교，A 조유도、술중적생명체정중 BP、HR 등경평은（P ＜0.05）；술필청성병가발제기관도관적례수경다（P ＜0.05），병사솔경저。결론재휴극조기환자중응용Narcotrend 뇌전감측지도마취，유조우제고환자창구적성공솔。
Objectve To investigate the value of narcotrend monitoring for anesthesia in the pation of shock early. Methods Sixty ASA Ⅲ or Ⅳ patients were randomized into 2 groups: Narcotrend monnitoring (group A) and standard practice group (group B). Group A manitained NT between D2-E1 levels by adjusting the propofol TCI rate and remifentail infision rate. Group B adjusted the two drugs according to the clinical practice. The narcotrend values, the mean arterial pressure (MAP), heart rate (HR), pules oxygen saturation (SpO2), the extubation rate and the death rate were recorded. Results The distributin of the Narcotrend substage within target level D2-E1 in group A which was higher than that of group B (P<0.05). The rate of extubation was significantly higher in group A compared with group B (P<0.05). The death rate was lower in group A than B. Conclusion It is contribute to improve the successrate of rescue patients when you use the narcotrend monitoring in the shock of patient anesthesia.