咪唑安定在早期食管癌及其癌前病变内镜治疗过程中的镇静作用

目的：探讨咪唑安定在早期食管癌及其癌前病变内镜治疗过程中的镇静作用。方法：在对99例早期食管癌及其癌前病变行内镜下黏膜切除及氩气等离子凝固治疗过程中，静脉应用咪唑安定进行镇静。进镜前2min静脉给予咪唑安定，首次剂量为2mg，治疗前常规静脉追加1mg，根据情况间隔2min以上可追加1mg，但总剂量不超过5mg。术中观察镇静分级及术中症状。术后评价病人对治疗过程的配合程度、感受、耐受程度及记忆缺失情况。治疗过程中给予病人持续吸氧，持续心电、血氧、血压、脉搏监测。结果：本组患者咪唑安定剂量均≤5mg，其中97例（98％）在患者治疗过程中无焦虑且能配合治疗。7例（8％）患者治疗时略有不适，无1例患者不能耐受内镜治疗。74例（75％）患者对内镜治疗过程记忆缺失，25例（25％）患者记忆或部分记忆。治疗成功率100％，无1例并发症及意外发生。除1例由于病人肝功能欠佳出现嗜延外，余无不良反应及副作用。结论：咪唑安定在一定剂量（≤5mg）范围内作为早期食管癌及其癌前病变内镜治疗的镇静用药是安全有效的。

SEDATION FOR ENDOSCOPIC THERAPY OF EARLY ESOPHAGEAL CANCER AND SEVERE DYSPLASIA WITH MIDAZOLAM

Objective:To study the effect of Midazolam in endoscopic therapy to severe dysplasia and early esophageal cancer on sedation.Method:Ninty nine patients undergoing esophageal mucosal resection(EMR) and Argon Plasma Coagulation(APC) under sedation with intravenously given midazolam. The first dose of midazolam is two milligramme, then it can be added another one milligarmme at two minutes interval, but total dose of midazolam is not more than five milligramme, the sedation scores,symptom, HR and SPO 2 were observed.Result:Whole patients were not more than five milligramme, ninty seven patients were cooperation and without anxiety during therapy, seven patients had slightly uncomfortable, seventy four patients lost their memory to endoscopic therapy, all therapy are successful. No one could not endure endoscopic therapy, except one patient with liver dysfunction is sleepy, no one case have accident and side effect. Conclusion:Midazolam (5mg)can produce safe and effective sedation for endoscopic therapy during endoscopic Mucosal Resection and Argon Plasma Coagulation.