BIS监测与RAS评分在肺性脑病有创机械通气患者镇静中相关性分析

发布时间：2018-04-18 12:11

本文选题：脑电双频指数 + 镇静程度评分表　；参考：《中国现代医学杂志》2017年27期

【摘要】：目的分析脑电双频指数(BIS)与镇静程度评分表(RASS)在接受有创机械通气的肺性脑病患者中镇静深度评估的相关性。方法选择接受有创机械通气的肺性脑病患者38例,予以丙泊酚或咪唑安定静脉泵入治疗确保患者达到合理镇静目标。每位患者均间隔30 min分别记录BIS指数与RASS,比较RASS对应各阶段BIS指数中位数的总体差异。应用等级相关分析BIS指数与RASS的相关性。计算BIS指数评估镇静不足与镇静过度的敏感性以及相应约登(Youden)指数,确定BIS指数评估镇静程度的临床价值。结果 RASS对应各阶段BIS指数中位数间差异有统计学意义(P0.05),且等级相关分析BIS指数与RASS呈负相关(r=-0.824,P0.05);患者镇静程度从不足到过度,BIS指数中位数降低(P0.05)。合理镇静时,RASS为-3~0级,对应的BIS指数中位数(95%CI)分别为67(61,73)、70(66,76)、83(80,85)和89(87,94)。患者镇静不足时,BIS指数中位数为81,其敏感性及约登指数最大,分别为0.87和0.16;而镇静过度时,BIS指数中位数为46,其敏感性及约登指数最大,分别为0.98和0.78。结论 BIS指数与RASS具有良好的相关性,能较好地监测接受有创机械通气的肺性脑病患者镇静程度。
[Abstract]:Objective to analyze the correlation between bispectral index (BIS) and sedation score (RASS) in patients with pulmonary encephalopathy undergoing invasive mechanical ventilation.Methods 38 patients with pulmonary encephalopathy who received invasive mechanical ventilation were treated with propofol or midazolam.Each patient had 30 min interval to record BIS index and RASS, and to compare the overall difference of BIS index median in RASS corresponding to each stage.The correlation between BIS index and RASS was analyzed by rank correlation.The BIS index was calculated to evaluate the sensitivity of sedation deficiency and excessive sedation and the corresponding Youden index to determine the clinical value of BIS index in evaluating sedation.Results there was significant difference in the median of BIS index between different stages of RASS, and there was a negative correlation between BIS index and RASS, and a negative correlation between BIS index and RASS, while the median of BIS index decreased from insufficient to excessive.For rational sedation, the RASS was -3 ~ 0, and the corresponding median BIS index was 67 / 61 / 73 ~ 70 / 676 / 83 / 80 / 85) and 8987 / 94 respectively.The median of BIS index in patients with insufficient sedation was 81, the sensitivity and Yorden index were the highest (0.87 and 0.16, respectively), while the median of BIS index in patients with excessive sedation was 46, their sensitivity and Yorden index were the highest (0.98 and 0.78, respectively).Conclusion there is a good correlation between BIS index and RASS, which can monitor the sedation degree of pulmonary encephalopathy patients receiving invasive mechanical ventilation.
【作者单位】：湖南省长沙市第一医院重症医学科;
【分类号】：R563.9;R747.9

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