咪达唑仑在肝脏恶性肿瘤TACE治疗中的应用

目的探讨咪达唑仑在肝脏恶性肿瘤TACE治疗中应用的临床效果。方法对30例接受TACE的原发性或转移性肝脏肿瘤患者于术前肌内注射咪达唑仑注射液0.06mg/kg体质量,并于注射前、注射后10、30、50min分别监测心率(HR)、血压(BP)、血氧饱和度(SpO2)。TACE术中使用Ramsay改良分级法评价患者镇静状况,术后评价患者对手术过程及术中不良反应的遗忘情况。结果患者术前平均BP偏高,用药后各时间段HR和BP与用药前相比均有所下降(P均<0.01);镇静评价1级7例,2级23例。术后对手术过程及痛苦感受遗忘评价,完全遗忘22例(22/30,73.33%),不完全遗忘8例(8/30,26.67%)。结论 TACE术前使用咪达唑仑,可以迅速起到镇静、催眠和顺行性遗忘作用,适合在动态生命体征监测下使用,为介入治疗前理想的镇静药物。

Application of Midazolam in TACE of malignant hepatic tumors

Objective To investigate the clinical effects of Midazolam in TACE treatment for malignant hepatic tumors. Methods Thirty patients with primary or metastatic hepatic tumors received intramuscular injection of Midazolam (0.06 mg/kg) before TACE. Heart rate (HR), blood pressure (BP) and saturation of blood oxygen (SpO₂) were recorded and analyzed before and 10, 30 and 50 minutes after the injection. Patients' calm level was assessed by modified Ramsay method during TACE. Forgetfulness level of the painful feeling related to TACE was evaluated simultaneously. Results Average BP was higher than normal level before the injection of Midazolam. HR and BP decreased after injection (all P<0.01). Calm level 1 was recognized in 7 patients, and level 2 were in 23 patients. Twenty-two patients (22/30, 73.33%) obtained global amnesia, and 8 patents (8/30, 26.67%) experienced partial lethe. Conclusion Midazolam can produce excellent sedation, hypnosis and anterograde amnesia in patients undergoing TACE. At a circumstance of basic physiological monitoring, Midazolam is an effective and safe calm drug in interventional treatment.