脑电双频指数监测下指导右美托咪定治疗ICU病房谵妄患者的效果

Clinical Efficacy on the Treatment of Delirium in ICU Ward by BIS under the Guidance of Dexmedetomidine

目的观察应用脑电双频指数监测下指导右美托咪定治疗ICU谵妄患者的效果。方法选取2016年6月至2017年6月大连市第三人民医院ICU病房发生谵妄的患者共70例,随机分为BIS组35例及SAS组35例,分别根据BIS或SAS评估镇静深度调整右美托咪定每小时用量,记录各组镇静持续时间、单位时间的右美托咪定用法及累积用量,采用t检验、秩和检验或χ2检验比较两组之间的差异,从而评估BIS监测ICU病房谵妄患者的可操作性。结果 BIS组单位时间内用右美托咪定剂量高于SAS组[(13.54±11.82)μg/(kg·h)比(12.76±12.26)μg/(kg·h),P <0.05]。镇静达标率高于SAS组(79.3%比37.1%,P <0.05),镇静持续时间小于SAS组[14.0(12.7,17.3)比16.0(13.1,18.1),P <0.05],撤机时间短于SAS组[16.8(13.9,19.6)比18.1(14.8,20),P <0.05],谵妄持续时间短于SAS组[2(1.5,3.1)比6(4.3,8.9),P <0.05]。结论 BIS监测在指导ICU病房谵妄患者治疗中比SAS评估有较好的可操作性。

Objective To evaluate clinical efficacy on the treatment of delirium in ICU ward by BIS under the guidance of dexmedetomidine.Methods A total of 70 patients with delirium admitted to ICU ward from June 2015 to June 2017 in the Third People’s Hospital of Dalian,were selected and randomly divided into BIS group and SAS group,35 cases in each group.The patients were sedation by dexmedetomidine,and the sedation depth was adjusted according to BIS or SAS to adjust the hour dosage of dexmedetomidine.The use and cumulative dosage of dexmedetomidine for the sedative duration and unit time in group BIS and group SAS were recorded.T-tese,rank-sum test orχ2 test were used to evaluate the treatment of delirium in ICU ward by BIS under the guidance of dexmedetomidine.Results The dose of dexmedetomidine in group BIS was higher than that in group SAS[(13.54±11.82)μg/(kg?h)vs(12.76±12.26)μg/(kg?h),P<0.05).The standard of sedation was higher than that of group SAS(79.3%vs 37.1%,P<0.05),the time of sedation was lower than that of group SAS[14.0(12.7,17.3)vs 16.0(13.1,18.1),P<0.05],and the time of delirium was shorter than that of group SAS[16.8(13.9,19.6)vs 18.1(14.8,20),P<0.05].Conclusion BIS monitoring has better maneuverability than SAS in the treatment of delirium patients in ICU ward.