CAJ | 학술논문

目的：应用脑状态监测仪评价无痛纤维支气管镜检查的镇静效果，达到控制镇静剂的使用，减轻血流动力学波动，指导护理配合的目的。方法选择2011年10月至2012年10月急诊ICU病房危重症患者60例，按照随机数字表法分成两组，观察组连接脑状态监测仪评价镇静效果，对照组应用Ramsay评分评估镇静深度，两组分别根据监测结果调整丙泊酚用量，对两组患者血流动力学、血气分析、不良事件和护理工作量进行比较。结果观察组患者操作前后PO2差值为（10．954±1．598）mm Hg，明显高于对照组（8．289±1．184）mm Hg，两组比较差异有统计学意义（t＝2．191，P＜0．05）。观察组镇静总药量（9．58±2．472）ml，给药次数为（2．05±0．705）次，均少于对照组（12．55±3．096）ml，（2．55±0．567）次，两组比较差异有统计学意义（ t 值分别为-5．750，-4．229；P＜0．05）。观察组操作准备时间为（57．45±4．282） min，长于对照组（12．45±3．697） min，但用于评估镇静状态、给药的时间为（22．45±4．031）min，明显少于对照组（34．45±7．260）min，两组比较差异有统计学意义（t 值分别为55．177，62．320；P＜0．05）。结论将脑状态监测应用于纤维支气管镜检查的镇静监测，不仅可以量化监测深度，减少镇静药物的用量，还可以提高护理配合的质量。
목적：응용뇌상태감측의평개무통섬유지기관경검사적진정효과，체도공제진정제적사용，감경혈류동역학파동，지도호리배합적목적。방법선택2011년10월지2012년10월급진ICU병방위중증환자60례，안조수궤수자표법분성량조，관찰조련접뇌상태감측의평개진정효과，대조조응용Ramsay평분평고진정심도，량조분별근거감측결과조정병박분용량，대량조환자혈류동역학、혈기분석、불량사건화호리공작량진행비교。결과관찰조환자조작전후PO2차치위（10．954±1．598）mm Hg，명현고우대조조（8．289±1．184）mm Hg，량조비교차이유통계학의의（t＝2．191，P＜0．05）。관찰조진정총약량（9．58±2．472）ml，급약차수위（2．05±0．705）차，균소우대조조（12．55±3．096）ml，（2．55±0．567）차，량조비교차이유통계학의의（ t 치분별위-5．750，-4．229；P＜0．05）。관찰조조작준비시간위（57．45±4．282） min，장우대조조（12．45±3．697） min，단용우평고진정상태、급약적시간위（22．45±4．031）min，명현소우대조조（34．45±7．260）min，량조비교차이유통계학의의（t 치분별위55．177，62．320；P＜0．05）。결론장뇌상태감측응용우섬유지기관경검사적진정감측，불부가이양화감측심도，감소진정약물적용량，환가이제고호리배합적질량。
Objective To evaluate the sedative effect of anodynia fiberoptic bronchoscopy by using cerebral state monitor , in order to control the usage of sedatives , relieve hemodynamic fluctuations , and guide the nursing cooperation .Methods A total of 60 patients with emergency and serious diseases from October 2011 to October 2012 in emergency ICU ( EICU ) were selected and divided into two groups according to random number table method:the observation group and the control group .The sedative effect in the observation group of patients were evaluated by using cerebral state monitor , and the depth of sedation in the control group of patients were evaluated by using Ramsay Sedation Score .The dosage of propofol were adjusted according to the monitoring results in the two groups , respectively .The hemodynamics , blood gas analysis , adverse events and nursing workload were observed and compared among the patients in the two groups .Results After operation , the PO2 difference in the observation group of patients was (10.954 ±1.598) mm Hg, and significantly higher than (8.289 ±1.184) mm Hg in the control group of patients , the difference was statistically significant ( t=2.191, P<0.05).In the observation group, the total dosage of propofol was (9.58 ±2.472)ml, the frequency of administration was (2.05 ±0.705), both of which were less than (12.55 ±3.096)ml and (2.55 ±0.567) in the control group, the differences were statistically significance (t=-5.750, -4.229, respectively; P<0.05).The time of preparation for operation in the observation group was (57.45 ±4.282) min, and longer than that of (12.45 ±3.697) min in the control group, but the time to evaluate sedation and administrate medicine in the observation group was (22.45 ±4.031) min and were significantly less than (34.45 ±7.260) min in the control group, the differences were statistically significant (t=55.177,62.320, respectively; P<0.05).Conclusions The application of cerebral state monitoring technology in monitoring the sedation station of fiberoptic bronchoscopy examination can quantify the anesthesia monitoring depth and reduce the dosage of sedative, also can improve the quality of nursing cooperation .