›› 2010, Vol. 5 ›› Issue (01): 36-40.

• 论著 • 上一篇    下一篇

脑电双频指数监测在前交通动脉瘤性蛛网膜下腔出血躁动患者镇静治疗中的应用

温淼,王雪梅,鞠奕   

  1. 北京市首都医科大学附属北京天坛医院神经内科
  • 收稿日期:2009-06-03 修回日期:2009-05-03 出版日期:2010-01-20 发布日期:2010-01-20
  • 通讯作者: 温淼

The Application of Bispectral Index in Sedative Treatment for Anterior Communicating Aneurysm Subarachnoid Hemorrhage

WEN Miao, WANG Xue-Mei, JU Yi.   

  • Received:2009-06-03 Revised:2009-05-03 Online:2010-01-20 Published:2010-01-20
  • Contact: WEN Miao

摘要: 目的 探讨脑电双频指数(bispectral index BIS)指导下前交通动脉瘤合并精神症状患者的镇静治疗的量化管理。方法 全脑数字减影血管造影术(digital subtraction arteriography,DSA)证实为前交通动脉瘤破裂的急性期蛛网膜下腔出血合并精神症状的患者28例,随机分为监测给药组(BIS组)和对照组,每组14例。BIS组通过BIS监测将监测数值维持在70~85条件下调节镇静药咪达唑仑的用量,对照组则根据患者临床一般状况和医生临床经验调节咪达唑仑的用量,分别记录两组患者的BIS值、Ramsay评分、心率、血压、血氧饱和度、给药总剂量、以及镇静相关不良事件等。结果 随给药时间延长BIS组BIS值、Ramsay评分及血氧饱和度高于对照组,对照组平均动脉压和心率波动幅度高于BIS组,BIS组患者镇静药物持续给药总量较对照组少,无相关不良事件发生。结论 BIS监测对于前交通动脉瘤破裂合并精神症状患者的镇静治疗有量化指导作用。

关键词: 脑电描记术; 咪达唑仑; 精神障碍; 清醒镇静; 监测; 生理学; 颅内动脉瘤

Abstract: Objective To investigate the quantificat sedation value of bispectral index (BIS) in anteriorcommunicating aneurysms patients with psychiatric symptom.Methods Twenty-eight acute subarachnoid hemorrhage patients with psychiatric symptom whohad been confirmed with anterior communicating aneurysms by DSA were included. All patientsaccepted Midazolam. They were divided randomly into two groups, 14 in BIS group with adjustingsedative sedation between BIS 70-85, and other 14 in control group with experience dosage.BIS,HR, BP, SPO2, dosage, badness were monitored continuously and Ramsay sedation scale wasassessed.Results Accompanying longer treatment, the BIS, Ramsay sedation scale and SPO2 of BIS groupwere higher gradually than those of control group. The fluctuate of MABP, HR was obviouslyincreased in control group. The total continuing medication dose was decrease in BIS group, whichwithout badness happening.Conclusion The BIS is suitable for monitoring the depth of sedation of anterior communicatinganeurysms patients with psychiatric symptom.

Key words: Electroencephalography; Midazolam; Mental disorders; Conscious sedation; Monitor; physiologic; Intracranial aneurysm