CAJ | 학술논문

目的探讨原发性肝癌(HCC)患者行动脉化疗栓塞(TACE)术前应用镇静药物的效果及安全性.方法 156例HCC患者均为首次接受TACE治疗,随机分为四组.空白组30例,TACE术前肌注生理盐水10 ml;地西泮组42例,TACE术前肌注地西泮10 mg;异丙嗪组42例,TACE术前肌注异丙嗪25 mg;联合组42例,TACE术前肌注地西泮10 mg及异丙嗪25 mg.观察四组患者术中镇静、不良感觉及焦虑等情况.结果收缩压差及心率差:空白组明显高于其他三组,差异有统计学意义;地西泮组与异丙嗪组差异无统计学意义;而联合组与地西泮组或异丙嗪组比较差异均有统计学意义.镇静评价:0级患者空白组、地西泮组、异丙嗪组、联合组分别为30例、11例、18例、0例;1级患者空白组、地西泮组、异丙嗪组、联合组分别为0例、21例、15例、24例;2级患者空白组、地西泮组、异丙嗪组、联合组分别为0例、10例、9例、18例;四组无3、4级病例.焦虑值:空白组明显高于其他三组,差异均有统计学意义;地西泮组、异丙嗪组和联合组三组间差异无统计学意义.四组患者不良感觉的发生率差异无统计学意义.结论 TACE术前肌注地西泮联合异丙嗪能够有效的镇静,降低患者术中的应激反应及焦虑情绪,提高患者对TACE手术的耐受性.
목적 탐토원발성간암(HCC)환자행동맥화료전새(TACE)술전응용진정약물적효과급안전성.방법 156례HCC환자균위수차접수TACE치료,수궤분위사조.공백조30례,TACE술전기주생리염수10 ml;지서반조42례,TACE술전기주지서반10 mg;이병진조42례,TACE술전기주이병진25 mg;연합조42례,TACE술전기주지서반10 mg급이병진25 mg.관찰사조환자술중진정、불량감각급초필등정황.결과 수축압차급심솔차:공백조명현고우기타삼조,차이유통계학의의;지서반조여이병진조차이무통계학의의;이연합조여지서반조혹이병진조비교차이균유통계학의의.진정평개:0급환자공백조、지서반조、이병진조、연합조분별위30례、11례、18례、0례;1급환자공백조、지서반조、이병진조、연합조분별위0례、21례、15례、24례;2급환자공백조、지서반조、이병진조、연합조분별위0례、10례、9례、18례;사조무3、4급병례.초필치:공백조명현고우기타삼조,차이균유통계학의의;지서반조、이병진조화연합조삼조간차이무통계학의의.사조환자불량감각적발생솔차이무통계학의의.결론 TACE술전기주지서반연합이병진능구유효적진정,강저환자술중적응격반응급초필정서,제고환자대TACE수술적내수성.
Objective To investigate the efficacy and safety of using various sedative regimens during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods 156 HCC patients were randomly divided into four groups.The control group (n =30):intramuscular injection of 10 ml saline;The diazepam group (n =42):intramuscular injection of 10 mg of diazepam;The promethazine group (n =42):intramuscular injection of promethazine 25 mg;and The combined group (n =42):intramuscular injection of 10 mg of diazepam and promethazine 25 mg.Results The blood pressure and heart rate of the control group was significantly higher than the other three groups,while the combined group was significantly lower than the diazepam and the promethazine groups.The sedative rating:Grade 0 of the four groups were:30,11,18,0 patients respectively;Grade 1 of the four groups were:0,21,15,24 patients respectively;Grade 2 of the four groups were:0,10,9,18 patients respectively;No patients were in grades 3 and 4.The anxiety score of the control group was significantly higher than the other three groups.There was no significant difference in complications among the four groups.Conclusion Diazepam and/or promethazine could be used effectively and safely during TACE,and they could reduce stress response of HCC patients during TACE,and improved tolerance of TACE.