脑电双频指数在儿科ICU镇静监测的临床应用价值

Sedation assessment by using bispectral index in the pedintric intensive care unit

目的探讨脑电双频指数（BIS）在儿科ICU危重患儿镇静深度监测中的应用价值。方法前瞻性收集我院PICU的42例6个月～13岁的危重患儿，以咪唑安定持续静脉滴注镇静治疗，在应用镇静剂后的10个时间段以Ramsay评分评价镇静深度的同时进行BIS监测，分析BIS与Ramsay评分在儿童危重症镇静评估的相关性及影响因素。结果42例危重症患儿中共采集420对BIS与Ramsay对照数据，并做Spearman等级相关分析，BIS与Ramsay评分呈明显负相关（r＝－0．8879，P〈0．01）；在6个月－1岁患儿数据分析中，BIS与Ramsay评分无相关性（r=0．8427，P〉0．05）；BIS范围在55—80之间为危重症患儿合适的镇静分值。结论BIS与Ramsay评分在危重症镇静深度评估中具有较好相关性。BIS监测具有操作简单、省时、连续性好等优点，可作为PICU患儿镇静深度判断的客观指标。

Objective To evaluate the applicability of bispectral index （BIS） in assessing sedation in pediatric intensive care unit. Methods Patients in pediatric ICU, aged six months to thirteen years and requiring sedation were given midazolam as sedative drug. The Ramsay score was assessed by physicians after midazolam was given at ten time interval and these data were compared with the blinded BIS score. Results A total of 42 children were included in the study ,420 valid paired observation of BIS values and Ramsay score were performed. According to Spearman＇s scale analysis, the correlation coefficient between BIS value and Ramsay score was - 0. 887 9（ P 〈 0. 01 ）. But the correlation coefficient between BIS value and Ramsay score in the small age group（ age from 6 months to 1 year） was 0. 842 7 （ P 〉 0. 05 ）. Conclusion BIS values correlate fairly well with the Ramsay scores in PICU patient. With the advantages such as simpleness, time-saving, continuity and etc, BIS monitoring is a good objective tool for judging sedation depth of PICU patients.