摘要
目的:探讨脑电双频指数(BIS)监测下镇静联合亚低温治疗在颅脑术后重症患者的临床应用。方法:将40例颅脑手术重症患者按治疗方式不同分为对照组和观察组,每组各20例。对照组采用常规治疗,观察组在常规治疗基础上加BIS监测下镇静联合亚低温治疗,比较两组患者在治疗前(T0)及治疗后第1天(T1)、第3天(T2)和第5天(T3)的心率(HR)、平均动脉压(MAP)、血清C反应蛋白(CRP)、纤维蛋白原(FBG)、活化部分凝血活酶时间(APTT)水平及急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)和格拉斯哥昏迷评分(GCS)。结果:两组患者在T0的HR、MAP、CRP、FBG、APTT水平及APACHEⅡ和GCS评分比较,差异均无统计学意义(P>0.05);两组患者HR和MAP水平在T1、T2和T3逐渐降低,且均维持在正常水平,但观察组HR和MAP水平优于对照组(P<0.001);两组患者CRP水平在T1、T2、T3逐渐降低,且观察组在T1、T2、T3低于对照组(P<0.001);两组患者FBG水平在T1、T2依次升高,T3有所回落,但观察组在T1、T2、T3高于对照组(P<0.01);两组患者APTT水平在T1、T2、T3均低于T0,且观察组低于对照组(P<0.001);两组患者APACHEⅡ评分和GCS评分在T1、T2、T3逐渐升高,且观察组在T1、T2、T3均高于对照组(P<0.01)。结论:颅脑术后重症患者通过BIS监测下镇静联合亚低温治疗有利于缓解炎症反应和改善凝血功能等方面而促进康复,值得临床推广应用。
Objective:To investigate the clinical application of sedation under bispectral index(BIS)monitoring combined with mild hypothermia in severe patients after craniotomy.Methods:40 severe patients after craniotomy were selected as the research objects,they were randomly divided into observation group(n=20)and control group(n=20).The control group received routine treatment after craniotomy.The observation group received sedation under BIS monitoring combined with mild hypothermia on the basis of the control group.Before treatment(T0),on the first day(T1),on the third day(T2)and on the fifth day(T3),the heart rate(HR),mean arterial pressure(MAP),serum C-reactive protein(CRP),fibrinogen(FBG),activated partial thromboplastin time(APTT)levels,coagulation function,APACHEⅡ and GCS were measured.Results:There was no significant difference in HR,MAP,CRP,FBG,APTT,APACHEⅡ and GCS scores between the two groups(P>0.05).HR and MAP levels of the two groups gradually decreased at T1,T2 and T3,and were maintained at normal levels,however,HR and MAP levels in the observation group were better than those in the control group(P<0.001).The levels of CRP in the two groups decreased in turn,and those in the observation group were lower than those in the control group at the time of T1,T2 and T3(P<0.001).At the time of T1 and T2,the level of FBG in the two groups increased in turn and decreased at the time of T3.At the time of T1,T2 and T3,the FBG levels of the observation group was higher than that of the control group(P<0.01).At the time of T1,T2 and T3,the level of APTT in the two groups was lower than that of T0,and that of the observation group was lower than that of the control group(P<0.001).The ApacheⅡ score and GCS score of the two groups were increased in turn,and the observation group were higher than the control group at the time of T1,T2,T3(P<0.01).Conclusion:The combination of sedation under BIS monitoring and mild hypothermia is beneficial to reduce the level of serum inflammatory factors,improve the coagulation function and promote the recovery of patients after craniotomy,which is worthy of clinical application.
作者
程乐平
鲁厚清
CHENG Le-ping;LU Hou-qing(Department of Critical Care Medicine,Tongling People's Hospital,Tongling 244000,Anhui,China)
出处
《川北医学院学报》
CAS
2021年第2期242-245,共4页
Journal of North Sichuan Medical College
关键词
颅脑术后
重症患者
脑电双频指数
亚低温
镇静
After craniotomy
Svere patients
Severe Bispectral index
Mild hypothermia
Sedation
