自发性脑出血术后的短程强化镇静治疗

Short-course intensive sedative therapy for post-operative spontaneous intracerebral hemorrhage

目的评估自发性脑出血术后短程强化镇静治疗的安全性和有效性。方法将脑出血手术后患者分为强化镇静组和传统镇静组，分别接受目标疗程不超过12h的镇静治疗。强化镇静组镇静目标为Riker镇静一躁动评分（SAS）1—2分，传统镇静组镇静目标为3—4分。结果与传统镇静组相比，短程强化镇静组的术后前12h镇静程度深，镇静时间长，术后前12h收缩压、舒张压均较低，手术后第2d的残余血肿量以及再出血明显减少。同时短程强化镇静组患者的重症监护病房（ICU）住院天数没有延长，呼吸机相关性肺炎（VAP）的发生率没有增加。而且强化镇静组患者的死亡率、生存质量均优于对照组。结论在自发性脑出血术后应用短程强化镇静治疗是安全、有效的。

Objective The effect and safety of short-course intensive sedative therapy for post-operative spontaneous intracerebral hemorrhage are discussed. Methods The patients were divided into intensive sedation group with sedative target for Riker sedation-agitation scale （SAS） 1 ～ 2 and traditional sedation group with sedative target for SAS 3 ～4, respectively. All patients received sedation therapy for no more than 12 h. Results Compared with the traditional sedation group, sedation of 12 h post-operation in short-course intensive sedation group was deep and long; the systolic pressure and diastolic pressure in 12 h post-operation was low and the volume of residual hematoma at 2 d post-operation was less. Meanwhile ICU hospitalization of short-course intensive sedation group did not prolong and the incidence of ventilator-associated pneumonia （VAP） was not increased. Conclusion Short- course intensive sedative therapy is effective and safe for post-operative spontaneous intracerebral hemorrhage.