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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 ,2 5例 (2 5 % )患者记忆或部分记忆。治疗成功率 1 0 0 % ,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睡外 ,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。
Objective: To investigate the sedative effect of midazolam during endoscopic treatment of early esophageal cancer and its precancerous lesions. Methods: During the treatment of 99 cases of early esophageal cancer and its precancerous lesions by endoscopic mucosal resection and argon plasma coagulation therapy, intravenous midazolam was used for sedation. Midazolam administered intravenously 2 minutes before the first intravenous injection, the first dose of 2mg, conventional intravenous additional 1mg before treatment, according to the situation more than 2min interval can be added 1mg, but the total dose does not exceed 5mg. Intraoperative observation of sedation classification and intraoperative symptoms. Postoperative evaluation of patients with the treatment process with the degree of feeling, tolerance and memory loss situation. Patients were given continuous oxygen during treatment, continuous ECG, blood oxygen, blood pressure, pulse monitoring. Results: The dosage of midazolam in this group was all ≤ 5 mg, of which 97 patients (98%) had no anxiety and could cooperate with the treatment. Seven patients (8%) were slightly ill at the time of treatment, and none of the patients were refractory to endoscopic treatment. 74 (75%) patients had no memory during endoscopic therapy and 25 (25%) patients had memory or partial memory. Treatment success rate was 100%, no complications and accidents occurred. In addition to 1 patient due to poor liver function appear lethargy, I no adverse reactions and side effects. CONCLUSION: Midazolam is safe and effective as a sedative drug for endoscopic treatment of esophageal cancer and its precancerous lesions at a dose (≤5mg).