脑电双频指数联合躁动-镇静评分在机械通气患者镇静评价中的应用效果  

Application effect of bispectral index combined with Richmond agitation-sedation score in the sedation evaluation of patients with mechanical ventilation

作　　者：熊玉 王瑾 彭美娜 彭滨菲 李剑智[1] 刘娟[1] 万辛闻 XIONG Yu;WANG Jin;PENG Meina;PENG Binfei;LI Jianzhi;LIU Juan;WAN Xinwen(Department of Intensive Care Unit,Nanchang First Hospital,Jiangxi Province,Nanchang330008,China;Department of Transitional Ward,Jiangxi Cancer Hospital,Jiangxi Province,Nanchang330000,China)

机构地区：[1]江西省南昌市第一医院急诊医学科,江西南昌330008 [2]江西省肿瘤医院过渡病房,江西南昌330000

出　　处：《中国当代医药》2022年第13期32-35,43,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(20204028)。

摘　　要：目的探讨脑电双频指数(BIS)联合躁动-镇静评分(RASS评分)在机械通气患者镇静评价中的应用效果。方法选取2019年12月至2020年6月南昌市第一医院急诊监护病房(EICU)收治的60例行机械通气患者作为研究对象,采用随机数字表法将其分成对照组(30例)与实验组(30例),对照组仅按常规的镇静治疗,实验组采用BIS结合RASS评分来指导镇静治疗。比较两组患者EICU医治时间、镇静药品使用总量、机械通气时间、EICU诊疗期间的不良反应产生情况和总住院时间等。结果实验组患者EICU住院时间、机械通气时间短于对照组,不良事件总发生率低于对照组,差异有统计学意义(P<0.05)。两组患者总住院时间比较,差异无统计学意义(P>0.05)。实验组患者的咪达唑仑使用总量少于对照组,差异有统计学意义(P<0.05)。两组患者使用右美托咪定的总量比较,差异无统计学意义(P>0.05)。结论采用RASS评分联合BIS来指导镇静治疗能显著缩短机械通气时间、EICU治疗时间,减少镇静药物的剂量,降低不良事件总发生率,值得临床推广。Objective To investigate the application effect of bispectral index(BIS)combined with Richmond agitation-sedation scale(RASS)in the sedation evaluation of patients with mechanical ventilation.Methods A total of 60 patients with mechanical ventilation in the Emergency Intensive Care Unit(EICU)of Nanchang First Hospital from December 2019 to June 2020 were divided into control group(n=30)and experimental group(n=30)by the random number table method.The control group was treated only with routine sedation therapy,and the experimental group was treated with BIS combined with RASS score to guide sedation therapy.The treatment time of EICU,the total use of sedatives,the time of mechanical ventilation,the adverse reactions during the diagnosis and treatment of EICU and the total hospital stay were compared between the two groups.Results The duration of EICU stay and mechanical ventilation in experimental group was shorter than that in control group,and the total incidence of adverse events was lower than that in control group,with statistical significances(P<0.05).There was no significant difference in total hospital stay between the two groups(P>0.05).The total amount of Midazolam in experimental group was less than that in control group,the difference was statistically significant(P<0.05).There was no significant difference in the total amount of dexmedetomidine between the two groups(P>0.05).Conclusion Sedation therapy guided by RASS score combined with BIS can significantly shorten the time of mechanical ventilation,the time of EICU treatment,reduce the dose of sedatives and the total incidence of adverse events,which is worthy of clinical promotion.

关 键 词：镇静评分 机械通气 镇静评估 脑电双频指数 躁动-镇静评分 

分 类 号：R563[医药卫生—呼吸系统]