目的:探讨脑电双频指数(BIS)监测对神经外科重症监护病房(NICU)阵发性交感神经功能亢进(PSH)患者的临床护理效果。
方法:从2022年1月至2023年6月,对NICU中共30例继发于中度至重度颅脑损伤的PSH患者进行了BIS监测。记录患者阵发性交感神经过度活动评估(PSH-AM)评分。PSH患者一般出现3种状态:平静状态,癫痫发作状态,和用药后的状态。30名PSH患者在平静期间记录BIS值,在癫痫发作状态下,和用药后状态,这3个不同阶段的BIS值被分为A组,B,C,使用Kruskal-WallisH检验比较各组。
结果:Kruskal-WallisH检验得出H=22.599,P<0.001。H0对测试标准α=0.05,A组的BIS值,B,和C不同。A组和B组的BIS值成对比较后有差异,差异有统计学意义(调整后P=0.001)。B组和C组有不同的BIS值,差异有统计学意义(校正P=0.001);A组和C组BIS值无差异,差异无统计学意义(校正P=1.00)。
结论:以BIS值作为PSH患者的护理观察指标,可以使护理工作更加客观,合理,准确,减少PSH攻击的诱发因素,进一步减少PSH的攻击,节约护理资源,并帮助指导镇静剂使用的安全性评估。
OBJECTIVE: To investigate the clinical nursing effect of bispectral index (BIS) monitoring for paroxysmal sympathetic hyperactivity (PSH) patients in the neurosurgical intensive care unit (NICU).
METHODS: From January 2022 to June 2023, a total of 30 patients with PSH secondary to moderate to severe craniocerebral injury in the NICU were monitored for BIS. The patients\' paroxysmal sympathetic hyperactivity-assessment measure (PSH-AM) scores were recorded. PSH patients generally appear in 3 states: calm state, seizure state, and postmedication state. Thirty PSH patients\' BIS values were recorded during the calm period, during the seizure state, and postmedication state, and these 3 different stages\' BIS values were divided into groups A, B, and C, using the Kruskal-Wallis H test to compare groups.
RESULTS: The Kruskal-Wallis H test yielded a value of H=22.599, P <0.001. H0 was rejected against the test standard of α=0.05, and the BIS values of groups A, B, and C differed. The BIS values of group A and group B differed after a pairwise comparison, and the difference was statistically significant (adjusted P =0.001). Group B and group C had different BIS values, and the difference was statistically significant (adjusted P =0.001); group A and Group C had no difference in BIS values, and the difference was not statistically significant (adjusted P =1.00).
CONCLUSIONS: Taking BIS value as the nursing observation index for PSH patients can make nursing work more objective, reasonable, and accurate, reduce the inducing factors of PSH attack, further reduce the attack of PSH, save nursing resources, and help guide the safety assessment of sedative use.