【摘要】 目的:研究熵指数用于神经外科重症监护病房的镇静深度监测的临床价值。方法:将40例神经外科急性轻型颅脑损伤(Traumatic brain injury,TBI)拟行NICU亚低温治疗的患者ASA(Ⅰ～Ⅱ级)随机分为Ⅰ组和Ⅱ组,每组20例,选择咪唑地西泮进行治疗期镇静,采用喉罩建立人工气道,满足通气需求。Ⅰ组利用熵指数调节镇静深度,满足熵指数维持于40～60范围;Ⅱ组为临床经验组,根据生命体征调节镇静剂用量。记录镇静期间两组患者咪唑地西泮的用量、麻醉复苏时间,人工气道拔出时间及有无发生不良记忆。结果:两组监测方式均可满足亚低温患者治疗要求,Ⅰ组咪唑地西泮用量及麻醉复苏时间少于Ⅱ组(P<0.05),两组均未发现不良记忆。结论:选择熵指数行镇静深度监测,可有效地降低亚低温治疗患者镇静剂使用剂量,监护手段安全、可靠,减少不良记忆的发生率。更多还原

【Abstract】 Objective To investigate the effectiveness and feasibility of entropy in measuring the depth of sedation on patients with acute slightly head injury treatment under mild hypothermia.Methods Forty ASAⅠ～Ⅱ,patients undergoing acute slightly head injury treatment under mild hypothermia were randomly divided into two groups(n=20 each),all patients were maintained sedation with midazolam,intubated laryngeal mask airway(LMA) to administer mechanical ventilation,Ⅰgroup monitored by entropy at the same time,adjusted concentration of midazolam by maintaining entropy(RE) from 40 to 60;Ⅱgroup,according to hemodynamics data to adjust concentration of midazolam.All the following data were recorded,such as the dosage of drug during sedation,awaked time and the time of pulled out LMA when operation was end,whether happened awareness during mild hypothermia.Results All patients were safety.The values of entropy were lower after induction,intubation and during NICU than that before induction(P<0.05),then they increased when the patients opened eyes by doctor’s order at the end of the sedation,but not achieved primitive values.The dosage of midazolam and awake time after sedation of Ⅰgroup were lower than Ⅱ group(P<0.05).There was no awareness happened during sedation.Conclusion As a measuring the depth of sedation,entropy can be effectively used during sedation for the mild hypothermia therapy of acute slightly head injury,to achieve medication individually and reduce awareness rate during sedation.更多还原