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目的探讨小剂量咪唑安定在清醒镇静胃镜检查时的效果和安全性。方法 182例胃镜检查患者 ,随机分药物组和对照组 ,药物组操作前予缓慢静脉推注咪唑安定 0 .0 3～ 0 .0 5mg/kg ,速度为 1mg/ 30s,若清醒镇静诱导不成功 ,可追加使用咪唑安定每次 0 .5mg,但总量≤ 0 .0 7mg/kg。术后常规用氟马西尼进行清醒镇静拮抗 ,每次 0 .1～ 0 .2mg快速静脉注射 ,直至患者清醒。对照组操作前予缓慢静脉注射生理盐水 10ml。结果药物组患者 10 0 %清醒镇静诱导成功 ,全部患者无不适感觉 ,患者的遗忘程度分别为完全遗忘 86 .96 % ,部分遗忘 13.0 4 % ,全部患者认为效果满意 ,愿意再次接受检查 ;而对照组只有 2 5 %患者表示愿意再次接受检查 (P <0 .0 1)。对照组无一例感觉良好 ,6 6 .7%感觉不适 ,但尚能忍受 ,33.3%认为难以忍受 ,与药物组对比有显著性差异 (P <0 .0 1)。两组对呼吸循环功能影响均较小。结论胃镜检查时在严密监测下采用小剂量咪唑安定诱导清醒镇静的方法是有效和安全的 ,有利于胃镜诊断和治疗 ,值得在临床推广应用。
Objective To investigate the efficacy and safety of low dose midazolam in conscious sedation gastroscopy. Methods One hundred and eighty-two patients undergoing gastroscopy were randomized into two groups: the control group and the drug group. The patients in the drug group were injected with midazolam 0.3-0.05 mg / kg at a speed of 1 mg / , The additional use of midazolam 0.5mg each time, but the total ≤ 0. 0 7mg / kg. Postoperative routine flu methanesulfonic acid sedation antagonism, each 0. 1 ~ 0. 2mg intravenous injection, until the patient awake. Control group before the operation to slow intravenous injection of normal saline 10ml. Results Patients in the drug group were sedated with conscious sedation at 10%, and all patients had no discomfort. The degree of oblivion was 86.96% in patients with oblivion and 13.0% in patients with partial amnesia. All patients were satisfied with the results and were willing to take another examination. Only 25% of patients in the group indicated that they were willing to be tested again (P <0.01). None of the patients in the control group had a good feeling. Sixty-six.7% felt uncomfortable, but still able to endure, 33.3% considered unbearable. There was a significant difference (P <0.01) with the drug group. The two groups have little effect on respiratory function. Conclusion Gastroscopy in the close monitoring of small doses of midazolam induction of conscious sedation method is effective and safe, is conducive to endoscopy diagnosis and treatment, it is worth in the clinical application.