BIS监测个体化丙泊酚TCI应用于Ⅲ度烧伤患者中的优势分析  

Analysis of Advantages of BIS Monitoring Individual Propofol TCI for Ⅲ Degree Burn Patients

作　　者：喻茶秀 YU Chaxiu(The First Affiliated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第一附属医院,江西南昌330000

出　　处：《中国医学创新》2018年第1期119-122,共4页Medical Innovation of China

摘　　要：目的:探讨脑电双频谱指数(BIS)监测个体化丙泊酚靶浓度控制输注(TCI)应用于Ⅲ度烧伤患者中的优势。方法:选取本院2016年4月-2017年3月收治的Ⅲ度烧伤患者78例,按照随机数字表法分为对照组和BIS组,每组各39例,均择期行切痂术,且以丙泊酚TCI诱导和维持麻醉。对照组依照心率、血压调整TCI,BIS组则在BIS监测下调整丙泊酚TCI。观察两组麻醉前(T_0)、插管即刻(T_1)、插管5 min(T_2)、手术开始10 min(T_3)、术毕时(T_4)的平均动脉血压(MAP)、心率(HR)、收缩压(SBP)、舒张压(DBP),记录总丙泊酚使用量、术后苏醒时间、不良反应。结果:两组患者的MAP、HR、SBP与DBP不同时刻、组间和交互方面比较差异均有统计学意义(P<0.05)。除T_2与T_4外,对照组组内每两个时刻比较差异均有统计学意义(P<0.05)。但BIS组组内每两个时刻比较差异均无统计学意义(P>0.05),且除T_0外,BIS组的MAP、HR、SBP与DBP均明显高于对照组(P<0.05)。BIS组总丙泊酚使用量以及不良反应发生率均明显低于对照组(P<0.05),且BIS组术后苏醒时间明显短于对照组(P<0.05)。结论:BIS监测个体化丙泊酚TCI应用于Ⅲ度烧伤患者可维持血流动力学稳定,减少丙泊酚使用量,降低麻醉风险,不良反应发生较少,且苏醒迅速。Objective:To investigate the advantages of bispectral index(BIS)monitoring individual Propofol target concentration-controlled infusion(TCI)forⅢdegrees burn patients.Method:78 patients ofⅢdegrees burn were selected from April 2016 to March 2017 in our hospital,who were randomly divided into control group and BIS group,39 cases in each group.They were given selective escharectomy,Propofol TCI anesthesia to induce and maintain.The control group was adjusted Propofol TCI according to the heart rate and blood pressure,while the BIS group was adjusted Propofol TCI under BIS monitoring.The mean arterial blood pressure(MAP),heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)of the patients of two groups were observed before anesthesia(T0),immediately after intubation(T1),after 5 mins of intubation(T2),after 10 mins of operation(T3),at the end of operation(T4),the total application amount,postoperative recovery time and adverse reactions of two groups were recorded.Result:The MAP,HR,SBP and DBP were significantly different between moments,groups and interactions(P<0.05),of which the control group had significant difference at each two moments(P<0.05),except T2 and T4,of which the BIS group had no significant difference at each two moments(P>0.05).The MAP,HR,SBP and DBP of the BIS group were significantly higher than those of the control group except T0(P<0.05).The target concentration of Propofol and the incidence of adverse reactions of the BIS group were significantly lower than those of the control group(P<0.05),and the recovery time of the BIS group was significantly shorter than that of the control group(P<0.05).Conclusion:BIS monitoring individual Propofol TCI forⅢdegrees burn patients can maintain hemodynamics stability,reduce application amount of Propofol and the risk of anesthesia,with less adverse reactions and quick analepsia.

关 键 词：脑电双频谱指数 丙泊酚 靶浓度控制输注 烧伤 

分 类 号：R614[医药卫生—麻醉学]