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目的：观察咪达唑仑（咪唑安定）对心脏瓣膜置换术患者血流动力学的影响。方法：静注０２ｍｇ／ｋｇ咪唑安定进行诱导，局麻下插ＳｗａｎＧａｎｚ导管到肺动脉测血流动力学变化，用热稀释法测ＣＯ。结果：收缩压（ＳＰ）、舒张压（ＤＰ）、平均动脉压（ＭＡＰ）、心输出量（ＣＯ）、心指数（ＣＩ）、平均肺动脉压（ｍＰＡＰ）、肺动脉楔压（ＰＡＷＰ）和右室每搏功（ＲＶＳＷ）在给药后１０ｍｉｎ明显下降，对左室每搏功（ＬＶＳＷ）、全身血管阻力指数（ＳＶＲＩ）和心率（ＨＲ）无明显影响，气管插管和劈胸骨时，ＳＰ、ＤＰ、ＭＡＰ上升到给药前值，但ＣＯ、ＣＩ、每搏量（ＳＶ）、ｍＰＡＰ、ＰＡＷＰ仍有显著差异，术毕ＳＰ、ＤＰ、ＭＡＰ、ＣＯ、ＣＩ、ｍＰＡＰ和ＰＡＷＰ均明显低于诱导前值。结论：咪唑安定对心功能差的患者有一定的心肌抑制作用，但尚平稳，且能降低ｍＰＡＰ、ＰＡＷＰ，故尚能安全地用于心脏瓣膜置换术患者的诱导。
Objective: To observe the effect of midazolam (midazolam) on hemodynamics in patients undergoing heart valve replacement. Methods: Intravenous 0 2mg / kg midazolam induction, local anesthesia Swan Ganz catheter inserted into the pulmonary artery to measure hemodynamic changes, measured by thermal dilution CO. Results: Systolic pressure (SP), diastolic pressure (DP), mean arterial pressure (MAP), cardiac output (CO), cardiac index (CI), mean pulmonary arterial pressure (mPAP), pulmonary artery wedge pressure (PAWP) The stroke volume (RVSW) decreased significantly 10 min after administration and had no significant effect on left ventricular stroke stroke (LVSW), systemic vascular resistance index (SVRI) and heart rate (HR). During tracheal intubation and split sternum, SP, DP, MAP increased to the level before administration, but there was still significant difference between CO, CI, stroke volume (SV), mPAP and PAWP, and the levels of SP, DP, MAP, CO, CI, The former value. Conclusion: Midazolam has a certain myocardial inhibition in patients with poor cardiac function, but it is still stable, and can reduce mPAP, PAWP, it is still safe for cardiac valve replacement in patients with induction.