脑电双频指数在先天性心脏病患儿镇静程度评估中的运用  

Application of bispectral index in assessing the level of sedation for young infants with congenital heart disease

作　　者：蒋超[1] 徐丽华[1] 朱丽敏 徐卓明 黄悦 柳立平 

机构地区：[1]上海交通大学护理学院,200025 [2]上海儿童医学中心心胸外科重症监护室,200127 [3]上海儿童医学中心麻醉科,200127

出　　处：《中国小儿急救医学》2012年第4期376-379,共4页Chinese Pediatric Emergency Medicine

基　　金：世界健康基金会（HOPE-2010-5524-3）

摘　　要：目的评价和分析脑电双频指数（bispectralindex，BIS）与舒适行为量表（COMFORTbehaviorscale，COMFORTB）相关性，探讨运用BIS评估6个月～2岁先天性心脏病患儿术后镇静程度的意义。方法采用前瞻性研究方法选择50例先天性心脏病术后接受镇静治疗的患儿。两位研究者在预定的监测时间点同步、独立记录BIS值和使用COMFORTB量表评估患儿镇静程度，共获得375例次观察数据。运用Spearman等级相关和预测概率分析BIS与COMFORTB量表之间的相关性，判断BIS预测不同镇静程度的准确性。结果COMFORTB量表评分各等级（镇静过度、镇静适度和镇静不足）对应的BIS值分别为57．0±11．0、69．9±7．6和84．4±9．0。BIS值与COMFORTB量表等级评分呈中度相关（rs=0.63，P〈0.0001）。其中6个月～1岁组rs为n66，1-2岁组rs为n59（P均〈0．0001）。反映BIS能够正确预测不同镇静程度的预测概率值为0．85（P〈0．0001）。结论BIS是一项能准确、有效监测6个月-2岁先天性心脏病患儿术后镇静程度的客观指标。Objective To evaluate and analyze the degree of correlation between the bispectral index （BIS） and COMFORT behavior scale （ COMFORT B scale） and to explore the usability of BIS in assessing the level of sedation for young infants from 6 months to 2 years old after surgical repairs of congenital heart disease. Methods A prospective observational study was designed to involve 50 young infants to assess their postoperative sedation depth. Two investigators evaluated the level of sedation simultaneously and independ- ently by using BIS and COMFORT B scale at each fixed observational points. A total of 375 data sets were gathered by observations. Correlations between BIS value and COMFORT B scale were determined by using Spearman rank correlation test and prediction probability to evaluate the accuracy of the performance of BIS on various sedation depths. Results BIS values in correspondence with different level of sedation, which was divided into oversedation, adequate sedation, undersedation according to COMFORT B scale, were 57. 0 ± 11.0,69.9 ±7.6 and 84.4 ± 9.0. There was a moderate correlation between BIS values and COMFORT B scale （ rs = 0. 63, P 〈 0. 000 1 ）. The Spearman correlation between BIS and COMFORT B was rs = 0. 66 and r, = 0. 59 for the age groups 6 months - 1 year old and 1 - 2 years old, respectively （ P 〈 0. 000 1 ）. Prediction probability value which indicated BIS can correctly predict various levels of sedation was 0. 85 （ P 〈 0. 000 1 ）. Condusion BIS is an accurate and valid objective parameter to assess the level of sedation for young infants from 6 months to 2 years old.

关 键 词：脑电双频指数 先天性心脏病 镇静程度监测 

分 类 号：R614[医药卫生—麻醉学]