摘要
重症医学病房(intensive care unit,ICU)收治的危重病患者由于各种有创操作,自身疾病的疼痛、不可避免的噪声(监护设备、报警声)、气管导管、尿管、胃管等插管的隐形疼痛、对自身病情的担忧、焦虑等,使机体处于强烈的应激状态,为减轻疼痛、焦虑及躁动增加各器官的代谢负担,防止影响治疗效果,加重患者的病情。因此,镇痛和镇静作为重症医学病房患者的常规治疗,可以有效减轻对患者的不良刺激,从而确保治疗的正常进行。ICU目前对患者的镇痛镇静评估方式多为镇痛镇静评估量表,主要通过患者对外界非伤害性刺激的反应,治疗依从性等方面评估患者的镇痛镇静,其缺点是不能实时监测镇痛镇静程度的动态变化,易造成镇痛镇静过深或不足。量化脑电图具有实时监测麻醉深度的作用,现就脑电相关监测技术指导危重病患者镇痛镇静的应用进展进行综述。
Critically ill patients admitted to the intensive care unit(ICU)are usually strongly stressed due to various invasive operations,disease pain,inevitable noise(monitoring equipment and alarm sound),invisible pain of tracheal tube,urinary tube,gastric tube,worry and anxiety of their own conditions,etc.Therefore,there is a need to reduce metabolic burden of various organs caused by pain,anxiety,and restlessness,to prevent affecting the treatment effect,and aggravating the patients′condition.Analgesia and sedation,as a routine treatment for patients in ICU,can effectively reduce the adverse irritation to patients,and ensure the normal progress of treatment.The current ICU assessment of patients′analgesia and sedation is mostly the analgesia sedation assessment scale,which mainly evaluates patients′analgesia and sedation in terms of patient response to external non-harmful stimuli and treatment compliance.The disadvantage is that it cannot be monitored in real time.The dynamic changes in the degree of pain and sedation can easily lead to excessive or insufficient analgesia and sedation.Quantitative EEG has the function of real-time monitoring of the depth of anesthesia.This paper reviews the application progress of EEG-related monitoring technology to guide analgesia and sedation in critically ill patients.
作者
郑长伟
陈玲
孙宇
才莹
王琨
谢凤杰
ZHENG Changwei;CHEN Ling;SUN Yu;CAI Ying;WANG Kun;XIE Fengjie(Mudanjiang Medical University,Mudanjiang 157000,China;Department of Critical Care Medicine,Hongqi Hospital Affiliated to Mudanjiang Medical University,Mudanjiang 157000,China)
出处
《中国现代医生》
2022年第11期189-192,共4页
China Modern Doctor
关键词
脑电双频谱指数
光谱熵
镇痛镇静深度
危重病患者
镇痛镇静策略
EEG bispectral index
Spectral entropy
Depth of analgesia and sedation
Critically ill patients
Analgesia and sedation strategies
