丙泊酚诱导睡眠平衡术治疗顽固性失眠症的效果及安全管理

Effects and Safety Management of Propofol Induced Sleeping Balance on Obstinate Insomnia

目的探讨丙泊酚诱导睡眠平衡术治疗顽固性失眠症患者的疗效及其安全管理方法。方法采用便利抽样法选择第三军医大学大坪医院野战外科研究所VIP病房收治的72例顽固性失眠症患者为研究对象,在患者自愿并征得书面同意后给予丙泊酚诱导睡眠平衡术治疗。在治疗前后采用脑电涨落(encephalofluctuograph techrology,ET)测量仪、多导睡眠图(polysomnography,PSG)及里兹睡眠评估问卷(the leeds sleep evaluation questionnaire,LSEQ)对患者的睡眠情况进行评价,并采取完善的安全防护措施保障患者安全。结果治疗后兴奋性神经递质总量较治疗前有明显下降(P<0.05),治疗后兴奋与抑制平衡得到明显恢复。麻醉睡眠诱导后,患者在入睡情况、睡眠质量、警觉行为和总分等方面均有明显改善(P<0.05),而宿睡症状改善不明显。多导睡眠图显示,治疗前后患者在入睡时间、睡眠时间、睡眠效率和非快速眼球运动(nonrapid eyemovements,NREM)睡眠时间上均较治疗前有明显改善(P<0.05)。结论丙泊酚诱导睡眠平衡术是短时间内纠正顽固性失眠行之有效的方法,而科学的安全管理措施是治疗成功、防止意外发生的关键。

Objective To investigate the effects and safety management of propofol induced sleeping balance on obstinate insomnia.Methods Using convenience sampling method,72 patients with obstinate insomnia in VIP ward from Research Institute of Field Surgery of the Third Military Medical University were enrolled in the study.With patient＇s written informed consent,all the patients were treated by propofol induced sleeping balance.Comparisons were conducted in the sleep quality using the records of encephalofluctuograph techrology（ET）,polysomnography（PSG）and score of the leeds sleep evaluation questionnaire（LSEQ） before and after the therapy with optimized protection measures.Results The total amounts of excitable neurotransmitter were significantly decreased after therapy than before therapy（P0.05）.Balance of excitation and inhibition was significantly restored after the treatment.After induction of anesthesia sleep,significant improvements were observed in the sleep condition,sleep quality,vigilance behavior and in total score（P0.05）,with little improvement in hangover symptoms.Polysomnography showed that significant improvements were achieved in sleep time,sleep efficiency and sleep time of nonrapid eye movements（NREM） before and after the treatment（P0.05）.Conclusion Propofol induced sleeping balance is an effective and safe treatment for obstinate insomnia.Scientific safety management is the key to insure patient successful treatment and prevent accidents.