【摘要】 目的:探究脑电近似熵在麻醉深度监测中的应用。方法:以2017年1月～2018年1月择期行全麻手术的80例患者为研究对象,测定所有患者麻醉前、麻醉诱导5 min、术中60 min、麻醉苏醒时脑电双频指数(BIS)、脑电近似熵,且观察不同丙泊酚血浆浓度、改良镇静/警觉评分(MOAA/S)BIS值、脑电近似熵值的变化情况,Pearson相关性分析BIS、脑电近似熵值与丙泊酚血浆浓度的相关性。结果:麻醉诱导5 min、术中60 min BIS值、脑电近似熵值比麻醉前均显著降低(P<0.05),且术中60 min的值显著低于麻醉诱导5 min时的值(P<0.05);BIS值、脑电近似熵值随丙泊酚血浆浓度上升而下降,均呈显著负相关(P<0.05);脑电近似熵在MOAA/S评分0～1分变化中有显著差异(P<0.05),而BIS值无显著差异(P>0.05)。结论:脑电近似熵对丙泊酚药效变化评价效果与BIS相当,但其相对在麻醉镇静深度判断上有优势。更多还原

【Abstract】 Objective To explore the application of electroencephalogram(EEG) approximate entropy in the monitoring of the depth of anesthesia. Methods Eighty patients who received elective surgery under general anesthesia from January 2017 to January2018 were enrolled in this study. The bispectral index(BIS) and EEG approximate entropy of all patients were measured before anesthesia, at 5 min after induction, at 60 min after the beginning of surgery and at recovery from anesthesia. With different plasma concentrations of propofol and modified observer’s assessment of alertness/sedation scale(MOAA/S) scores, the changes of BIS value and EEG approximate entropy were analyzed. Finally, Pearson correlation analysis was performed to investigate the correlation of BIS and EEG approximate entropy with the plasma concentration of propofol. Results The BIS value and EEG approximate entropy at 5 min after induction and at 60 min after the beginning of surgery were significantly lower than those before anesthesia(P<0.05), and the values at 60 min after the beginning of surgery were significantly lower than those at 5 min after induction(P<0.05). The BIS value and EEG approximate entropy were negatively correlated with the plasma concentration of propofol(P<0.05). Moreover, statistical differences were found in the EEG approximate entropy when MOAA/S score was0-1(P<0.05), but there was no significant difference in BIS value(P>0.05). Conclusion Both EEG approximate entropy and BIS can effectively evaluate the therapeutic effects of propofol, but the former has more advantage in judging the depth of anaesthesia.更多还原