咪达唑仑在老年高血压患者拔牙术中的应用观察

目的：评价低流量咪达唑仑静脉泵入技术，对于老年高血压患者拔牙过程中血压升高的控制。方法：单盲、随机、对照临床实验。对照组和试验组各50例，分别给予心理疗法和咪达唑仑泵入控制血压，比较基础值、就诊后、拔牙前、拔牙中和拔牙后的血压变化。血压的数值变化采用均值t检验，拔牙过程中血压的波动比较，采用变异系数（CV）。结果：就诊后，2组患者血压都比基础值有明显升高，主要是收缩压的升高。采取心理疗法后血压降低不明显，整个拔牙过程维持在较高水平。采用咪达唑仑泵入技术后，血压对比基础值和对照组都有明显降低，但波动幅度较对照组大。结论：低流量咪达唑仑静脉泵入可以有效控制老年高血压病人拔牙时的血压升高。

A clinical study of blood pressure changes on elderly hypertensive patients during dental extraction under sedation of midazolam

Objective: The purpose of this study is to evaluate the changes in blood pressure of elderly hypertensive patients during dental extraction under sedation of continuous intravenous infusion of midazolam. Methods: The study was a single-blind randomly controlled trial. 100 elderly hypertensive patients undergoing tooth extraction were recruited for this study and were averagely divided into two groups. Each patient was given midazolam or consolation and relaxation. systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were recorded while they were under basal conditions, during anesthesia and dental extraction periods. Data were analyzed by t-test and coefficient of variation. Results: Under basal conditions, the mean blood pressure values of intervention group showed no difference compared with control group. Before extraction, mean values of SBP, DBP and HR (especially SBP) increased significantly compared with basal condition in control group and intervention group. During dental extraction, mean values of the intervention group significantly decreased compared with control group, while coefficient of variation in intervention group was higher than that in control group. Conclusion: Continuous intravenous infusion of midazolam has proved to be successful in reducing anxiety and stress before treatment, and in blood pressure control of elderly patients during tooth extraction.