脑电双频指数在机械通气患儿镇静程度的临床研究.docVIP

精品论文 参考文献 脑电双频指数在机械通气患儿镇静程度的临床研究 DOI：10.7504/nk2016010203 中图分类号：R587.1 文献标识码：A 　　摘要：目的探讨脑电双频指数(BIS)评价机械通气患儿镇静程度的可靠性和有效性。方法选择在2011年01月至2013年01月南通市第一人民医院机械通气治疗的23例患儿，均在机械通气后5～15 min内静脉推注咪达唑仑，直至达到镇静目标，设定镇静目标为BIS值60～80，分别记录达镇静目标后30min、60min、120min的吸氧浓度(FiO2)、经皮血氧饱和度(SpO2)以及BIS、SAS镇静评分，并进行相关性分析。结果23例患者均达镇静目标，患者镇静后RR、FiO2较镇静前显著下降，SpO2显著升高，差异均有统计学意义(P<0.05)；BIS值与主观评分间相关性良好，其中BIS值与SAS评分呈显著正相关(r=0.626，P<0.05)。结论：BIS是评价ICU机械通气患者镇静深度的良好客观指标。 　　关键词：脑电双频指数；镇静躁动评分；机械通气；镇静； 　　Study reliability of bispectral index in assessing the depth of sedation of patients under mechanical ventilation 　　Ye Lei ,the First People Hospital of Nan Tong, Nan Tong 226001 　　Email:ntyysl@163.com,China 　　[Abstract] Objective To study the feasibility and effectivity of bispectral index (BIS) monitor in assessing the depth of sedation in mechanically ventilated patients．Methods Twenty-three patients, who were receiving mechanical ventilation from January of 2011 to January of 2013 in ICU of the First People Hospital of Nang Tong, were enrolled in this study. All the patients were infused midazolam in 5 to 15 minutes after mechanical ventilation till BIS score reaching 60-80. 30 min, 60 min and 120 min later, the parameters of respiration，circulation and the depth of sedation (BIS, SAS) were respectively recorded. The correlation index was assessed．Results After receiving mechanical ventilation, all the 19 patients reached sedation. The respiratory rate and fraction of inspired oxygen significantly declined (P<0.05). A significant positive correlation between BIS and SAS score values was shown (r=0.626, P<0.05) while there was a markedly negative correlation between BIS. Conclusion BIS monitor is feasible for assessing the depth of sedationin of mechanically ventilated patients. 　　[Key words] bispectral index; sedation-agitation scale; mechanical ventilation; depth of sedation; 　　镇静治疗是机械通气患儿的常规治疗，镇静评估既可以避免镇静不足致人机对抗，意外脱管等，又避免镇静过度致拆机延迟，呼吸机相关肺炎等并发症。国内儿童镇静评估研究较少，临床多应用镇静躁动评分( sedation-a