脑电双频指数与镇静评分系统评价机械通气患儿镇静程度的对比研究

Comparative study on assessing sedation level of mechanically ventilated patients by bispectral index and sedation scoring systems

目的探讨脑电双频指数（BIS）评价儿童重症监护室（PICU）机械通气患儿镇静程度的可靠性和有效性。方法选择接受机械通气治疗的患儿19例,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30、60和120 min的吸氧浓度（Fi O2）,经皮血氧饱和度（Sp O2）以及BIS、镇静躁动（SAS）和Ramsay镇静量表（RSS）3种镇静评分,并对3种评分进行相关性分析。结果 19例患者均达镇静目标,患者镇静后Fi O2较镇静前显著下降,Sp O2显著升高（P〈0.05）;BIS值与主观评分间相关性良好,其中BIS值与RSS评分呈显著负相关（r=-0.650,P〈0.05）,与SAS评分呈显著正相关（r=0.626,P〈0.05）。结论用BIS监测评估机械通气患者镇静深度简单方便、同步有效,是评价ICU机械通气患者镇静深度的良好客观指标。

Objective To explore the feasibility and efficiency of bispectral index（BIS） monitor for assessing the sedation level of mechanically ventilated patients in the Pediatric Intensive C are Unit（PICU）.Methods A total of 19 patients who underwent mechanical ventilation were selected.Patients were intravenously injected with midazolam 5-15 min after mechanical ventilation until the BIS score reached 60-80.Then after 30,60,and120 min,the concentration of oxygen inhalation（FiO2）,transcutaneous oxygen saturation（SpO2）,and values and scores of BIS,sedation-agitation scale（SAS）,and Ramsay sedation scale（RSS） were recorded.The correlation of three sedation scales was analyzed.Results All patients were sedated.After being sedated,FiO2of patients significantly decreased and SpO2 significantly increased（P〈0.05）.BIS value was significantly correlated with subjective scores.BIS value was significantly and negatively correlated with RSS scores（r=-0.650,P 〈0.05） and significantly and positively correlated with SAS scores（r =0.626,P〈0.05）.Conclusion BIS monitor is a simple and efficient method to assess the sedation level of mechanically ventilated patients and an ideal objective index for assessing the sedation level of mechanically ventilated patients in ICU.