中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2009年
7期
681-683
,共3页
刘肆仁%陆锐%田颖%董蕾
劉肆仁%陸銳%田穎%董蕾
류사인%륙예%전영%동뢰
冠心病%介入治疗%药物镇静
冠心病%介入治療%藥物鎮靜
관심병%개입치료%약물진정
Coronary heart disease%Intervention%Sedation
目的 观察镇静药物咪唑安定及芬太尼在冠状动脉介入术应用中的安全性及其对血流动力学的影响.方法 150例行冠状动脉介入术患者,随机分为3组:50例在常规局部麻醉前给予生理盐水5ml静脉注射(对照组),50例给予0.04 mg/kg咪唑安定用生理盐水稀释至5 ml静脉缓慢注射(咪唑安定组),50例给予咪唑安定0.02 mg/kg联合芬太尼1.2μg/kg用生理盐水稀释至5 ml缓慢注射(联合芬太尼组),观察3组患者HR、血压、经皮血氧饱和度、患者镇静程度评分及脑电双频谱指数(BIS)变化,术后对患者镇静满意程度及术中相关并发症情况进行随访.结果 3组给药前MAP和HR差异均无统计学意义(F分别为3.34和2.98,P均>0.05),对照组术中MAP为(95.7±14.5)mm Hg,显著高于术前[(85.4±15.3)mm Hg,t=4.34,P<0.01],术中HR为(83.3±23.4)次/min,与给药前[(78.4±22.7)次/min]比较差异有统计学意义(t=3.37,P<0.01).对照组、咪唑安定组和联合芬太尼组术中BIS评分分别为(90.5±7.2)分、(75.5±12.8)分和(72.3±14.1)分,术后24 hVAS评分分别为(53.5±25.4)分、(58.8±18.2)分和(71.9±16.8)分,组间比较差异均有统计学意义(F分别为10.89和8.56,P均<0.01).结论 冠状动脉介入术前使用小剂量的咪唑安定及芬太尼可以缓解患者紧张焦虑情绪,提高手术耐受性及安全性,对血流动力学无明显影响.
目的 觀察鎮靜藥物咪唑安定及芬太尼在冠狀動脈介入術應用中的安全性及其對血流動力學的影響.方法 150例行冠狀動脈介入術患者,隨機分為3組:50例在常規跼部痳醉前給予生理鹽水5ml靜脈註射(對照組),50例給予0.04 mg/kg咪唑安定用生理鹽水稀釋至5 ml靜脈緩慢註射(咪唑安定組),50例給予咪唑安定0.02 mg/kg聯閤芬太尼1.2μg/kg用生理鹽水稀釋至5 ml緩慢註射(聯閤芬太尼組),觀察3組患者HR、血壓、經皮血氧飽和度、患者鎮靜程度評分及腦電雙頻譜指數(BIS)變化,術後對患者鎮靜滿意程度及術中相關併髮癥情況進行隨訪.結果 3組給藥前MAP和HR差異均無統計學意義(F分彆為3.34和2.98,P均>0.05),對照組術中MAP為(95.7±14.5)mm Hg,顯著高于術前[(85.4±15.3)mm Hg,t=4.34,P<0.01],術中HR為(83.3±23.4)次/min,與給藥前[(78.4±22.7)次/min]比較差異有統計學意義(t=3.37,P<0.01).對照組、咪唑安定組和聯閤芬太尼組術中BIS評分分彆為(90.5±7.2)分、(75.5±12.8)分和(72.3±14.1)分,術後24 hVAS評分分彆為(53.5±25.4)分、(58.8±18.2)分和(71.9±16.8)分,組間比較差異均有統計學意義(F分彆為10.89和8.56,P均<0.01).結論 冠狀動脈介入術前使用小劑量的咪唑安定及芬太尼可以緩解患者緊張焦慮情緒,提高手術耐受性及安全性,對血流動力學無明顯影響.
목적 관찰진정약물미서안정급분태니재관상동맥개입술응용중적안전성급기대혈류동역학적영향.방법 150례행관상동맥개입술환자,수궤분위3조:50례재상규국부마취전급여생리염수5ml정맥주사(대조조),50례급여0.04 mg/kg미서안정용생리염수희석지5 ml정맥완만주사(미서안정조),50례급여미서안정0.02 mg/kg연합분태니1.2μg/kg용생리염수희석지5 ml완만주사(연합분태니조),관찰3조환자HR、혈압、경피혈양포화도、환자진정정도평분급뇌전쌍빈보지수(BIS)변화,술후대환자진정만의정도급술중상관병발증정황진행수방.결과 3조급약전MAP화HR차이균무통계학의의(F분별위3.34화2.98,P균>0.05),대조조술중MAP위(95.7±14.5)mm Hg,현저고우술전[(85.4±15.3)mm Hg,t=4.34,P<0.01],술중HR위(83.3±23.4)차/min,여급약전[(78.4±22.7)차/min]비교차이유통계학의의(t=3.37,P<0.01).대조조、미서안정조화연합분태니조술중BIS평분분별위(90.5±7.2)분、(75.5±12.8)분화(72.3±14.1)분,술후24 hVAS평분분별위(53.5±25.4)분、(58.8±18.2)분화(71.9±16.8)분,조간비교차이균유통계학의의(F분별위10.89화8.56,P균<0.01).결론 관상동맥개입술전사용소제량적미서안정급분태니가이완해환자긴장초필정서,제고수술내수성급안전성,대혈류동역학무명현영향.
Objective To observe the safety of midazolam and fentanyl in coronary intervention and its effect on haemodynamics. Methods 150 cases undergoing coronary intervention were randomly divided into three groups(n=50 for each):the control group were given injection of 5 ml saline,midazolam group were given 0.04 mg/kg midazolam and combined fentanyl group were given injection of 0.02 mg/kg midazolam with 1.2μg/kg fent-anyl intravenously. Heart rate(HR),mean blood pressure(MAP),SpO<,2>,OAA/S and BIS were observed during the intervention and the patients' satisfaction and the incidence of complications were investigated. Results There was no significant difference among the three groups in MAP and HR (F=3.34,2.98,P>0.05). MAP increased from (95.7±14.5) mm Hg to (85.4±15.3) mm Hg after treatment (t=4.34,P<0.01) and HR increased from (83.3±23.4) times/min to (78.4±22.7) times/min in control group (t=3.37,P<0.01). BIS score was (90.5±7.2),(75.5±12.8) and (72.3±14.1) during intervention and 24 hVAS score was (53.5±25.4),(58.8±18.2) and (71.9±16.8) in control group,midazolam group and combined fentanyl group,with significant difference between groups (F=10.89,8.56,P<0.01). Conclusion Low dose of midazolam and fentanyl can make the patients calm,which relieves the tensity and anxiety and enhance the tolerance and safety of intervention but has no remarkable effect on bemodynamics.
