量化镇静在高血压脑出血患者术后早期平稳过渡中的应用研究  

Application research of quantitative sedation monitoring for patients with intracerebral hemorrhage in the early stage of post-operation

作　　者：钟贤良[1] 单爱军[1] 谢曼英[1] 梁建 钟源波 徐建忠 杜波[1] Zhong Xian-liang;Shan Ai-jun;Xie Man-ying;Liang Jian;Zhong Yuan-bo;Xu Jian-zhong;Du Bo(Department of Emergency,the Second Clinical College of Jinan University(Shenzhen People's Hospital),Shenzhen 518020,China)

机构地区：[1]暨南大学第二临床医学院(深圳市人民医院)急诊科,广东深圳518020 [2]暨南大学第二临床医学院(深圳市人民医院)神经外科,广东深圳518020

出　　处：《中国急救医学》2019年第11期1036-1039,共4页Chinese Journal of Critical Care Medicine

基　　金：深圳市卫计委重点课题提升项目(201506009);深圳市卫计委3030项目(SZLY2018007);深圳市人民医院中青年技术骨干科研培育项目(SZKYPY201923)。

摘　　要：目的探讨量化镇静在高血压脑出血患者术后早期平稳过渡中的临床应用价值.方法比较分析2017年2月至2019年2月期间实施量化镇静(量化镇静组,58例,采用脑状态监测仪实时监测下量化镇静)与2015年1月至2017年2月常规镇静治疗(常规镇静,58例)脑出血术后早期患者在24 h停用镇静药后的呼吸机脱机时间、镇静药物使用量、术后再出血发生率、ICU住院时间、肺部感染发生率等.结果量化镇静组呼吸机脱机时间(h:6.4±1.8 vs.15.2±2.2,P=0.00)、镇静药物使用量[μg/(kg·h):62.4±4.9 vs.90.7±8.8,P=0.00]、ICU住院时间(d:6.2±1.3 vs.9.4±1.6,P=0.01)、肺部感染发生率(12.1%vs.25.9%,P=0.02)均优于常规镇静组,两组间术后再出血发生率(3.4%vs.5.2%,P=0.34)比较差异无统计学意义.结论高血压脑出血患者开颅术后早期实施量化镇静,可以显著减少镇静药物的使用量,加快呼吸机脱机并缩短ICU住院时间,有利于患者术后早期平稳过渡.Objective To observe the clinical efficacy of quantitative sedation monitoring for hypertension intracerebral hemorrhage(HICH)patients in the early stage of post-operation using historical controlled study.Methods To compare and analyze the sedative use,the rebleeding incidence of post-operation,the ICU staying time and the infection incidence of pulmonary between the quantitative sedation group(58 cases)during 2017-02~2019-02 and the control group(58 cases)during 2015-01-2017-02 patients after sedative stopping using in 24 hours.Results The time of ventilator with drawal(h:6.4±1.8 vs.15.2±2.2,P=0.00),the amount of sedative use[pug/(kg•h):62.4±4.9 vs.90.7±8.8=0.00],the ICU staying time(d:6.2±1.3 vs.9.4±1.6,P=0.01)the infection incidence of pulmonary(12.1%vs.25.9%,P=0.02)in the quantitative sedation group were better than those of the control group.The rebleeding incidence of post-operation was no statistical difference between the two groups(3.4%vs.5.2%,P=0.34).Conclusion Quantitative sedation monitoring on patients with HICH after craniotomy in the early stage of post-operation can significantly reduce the amount of sedative use;promote the ventilator with drawal and shorten the ICU staying time.This is a conducive method to help patients with HICH go through the early stage after operation smoothly.

关 键 词：高血压 脑出血 镇静 镇痛 脑状态指数 

分 类 号：R47[医药卫生—护理学]