脑电双频指数监测联合SAS评分在慢性阻塞性肺疾病急性发作病人中应用的临床研究

Value of bispectral index monitoring combined with SAS score in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨脑电双频指数(bispectral index,BIS)监测在慢性阻塞性肺疾病急性发作(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)病人进行目标导向的镇静治疗中的应用。方法 62例AECOPD病人通过随机数字表法随机分成BIS组以及对照组。BIS组在常规丙泊酚镇静基础上采用BIS监测,过程中通过调整病人的丙泊酚输注速度使得病人的BIS值维持于60～80之间。对照组则采用常规镇静治疗,通过评估病人的Riker镇静、躁动评分(sedation-agitation scale,SAS)调整丙泊酚用量,使得病人的SAS评分维持在3～4分之间;记录2组在第0、12、24、36、48 h的SAS分值以及在48 h时的丙泊酚用量以及意外拔管率,并进行组间比较。结果 2组间SAS评分差异没有统计学意义。BIS组病人在达到可靠镇静治疗的同时丙泊酚用量显著低于对照组,差异有统计学意义(P<0. 05)。结论在AECOPD病人中进行BIS监测可以对病人实施可靠的镇静治疗的同时减少丙泊酚的用量,降低病人的意外拔管率。

Objective To investigate the use of bispectral index(BIS)in goal-directed sedation in the patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 62 cases of AECOPD were divided into two groups according to random digital table,BIS group and control group.In BIS group,the patients were given BIS monitoring based on conventional propofol sedation.The BIS value was maintained between 60-80 by adjusting the intravenous infusion speed of propofol during sedation.In control group,the patients were given conventional propofol sedation to maintain the score of sedation-agitation scale(SAS)ranging 3-4 by adjusting the intravenous infusion speed of propofol.The score of SAS,usage amount of propofol and the incidence rate of unexpected extubation at the time of 0,12,24,36,48h were recorded.Results The score of SAS did not show significant difference between both groups.The usage amount of propofol was significantly lower in BIS group than that in control group(P<0.05).Conclusions Applying BIS monitoring to sedate the patients with AECOPD can reduce the propofol usage.