脑电近似熵与双频指数在意识消失时预测概率的比较  

Comparison of unconsciousness prediction probability with approximate entropy and bispectral index during sedation

作　　者：欧阳铭文[1] 张宏[1] 

机构地区：[1]解放军总医院麻醉科,北京100853

出　　处：《南方医科大学学报》2006年第3期287-289,共3页Journal of Southern Medical University

基　　金：国家自然科学基金项目(30340075)~~

摘　　要：目的比较脑电非线性参数近似熵(ApEn)和双频指数(BIS)在异丙酚靶控输注(TCI)镇静时意识消失的预测概率(Pk)。方法随机选择20例美国麻醉医师协会(ASA)分级Ⅰ￣Ⅱ级行择期下肢手术患者,硬膜外麻醉完善后,异丙酚TCI起始血药浓度为0.5μg/ml,然后以0.3￣0.5μg/ml的梯度递增直至意识消失,再递减至意识恢复。每个靶浓度维持12min,双盲记录患者意识清醒.消失时的EEG非线性参数ApEn值和BIS值。计算ApEn和BIS对意识消失的Pk值,并进行比较。结果意识清醒和消失阶段,ApEn值分别为0.84±0.05,0.71±0.06,BIS值分别为80.2±6.2,67.3±7.9。ApEn、BIS对意识消失的Pk值分别为0.97±0.06、0.91±0.11,无显著性差异(P>0.05)。结论ApEn与BIS一样可有效地用于异丙酚TCI时意识反复消失-清醒的预测。Objective To compare the unconsciousness prediction probability（Pk） estimated by approximate entropy （ApEn） and bispectral index （BIS） during the sedation produced by target-controlled infusion （TCI） of propofol. Methods Twenty patients （ASA classⅠ-Ⅱ ） scheduled for elective lower limb operations under epidural anesthesia were studied. TCI of propofol was initiated at target plasma concentration of 0.5μg/ml, and increased by 0.3 to 0.5 μg/ml until loss of conscionsness, and then decreased until consciousness recovery. Each target plasma concentration ofpropofol lasted for 12 min. ApEn and BIS were recorded simultaneously during the periods of consciousness and unconsciousness every 3 min. The Pk of unconsciousness with ApEn and BIS were calculated and compared. Results ApEn was 0.84±0.05 in the state of consciousness and 0.71± 0.06 upon loss of consciousness, and BIS in the corresponding stages were 80.2±6.2 and 67.3±7.9, respectively. The Pk of unconscioussmess between ApEn （Pk=0.97±0.06） and BIS （Pk=0.91±0.11） did not significantly differ （P〉0.05）. Conclusion ApEn as well as BIS is acceptable for predicting consciousness and unconsciousness produced by TCI propofol.

关 键 词：意识消失 双频指数 近似熵 预测概率 靶控输注 

分 类 号：R614[医药卫生—麻醉学]