【摘要】 目的观察不同剂量的地佐辛复合咪达唑仑用于高强度聚焦超声消融子宫肌瘤的临床效果和安全性。方法择期行高强度聚焦超声消融子宫肌瘤的患者60例,ASAⅠ或Ⅱ级,随机分为3组,地佐辛0.1 mg/kg复合咪达唑仑组（D1组）、地佐辛0.15 mg/kg复合咪达唑仑组（D2组）、地佐辛0.2 mg/kg复合咪达唑仑组（D3组）,每组20例。分别用VAS评分和Ramsay评分评估镇痛和镇静效果。记录患者给药前（T₀）、给药后15 min（T₁）、聚焦治疗15 min（T₂）、术毕（T₃）及术后2 h（T₄）的平均动脉压（MAP）、心率（HR）、血氧饱和度（SpO₂）,记录VAS评分和Ramsay评分、术毕腹痛及不良反应发生率。结果与D1组比较,D3组患者MAP和HR在T1、T₂和T₃明显降低（P<0.05）;与T₁比较,D1组患者MAP和HR在T2明显上升（P<0.05）,D2组各时间点MAP和HR变化差异无统计学意义（P>0.05）;与D1组比较,D3组VAS评分低、Ramsay评分高（P<0.05）,D2组VAS评分和Ramsay评分与D3组比较差异无统计学意义（P>0.05）;D1组术毕腹痛和D3组不良反应发生率较D2组高（P<0.05）。结论地佐辛0.15 mg/kg复合咪达唑仑静脉麻醉能为高强度聚焦超声消融子宫肌瘤提供良好的镇痛镇静效果。更多还原

【Abstract】 Objective To investigate the clinical effect and safety of different doses of Dezocine with Midazolam in high-intensity focused ultrasound to ablate hysteromyoma. Methods Sixty sufferers waiting for high-intensity focused ultrasound to ablate hysteromyoma of ASA Ⅰ or Ⅱ were randomly divided into three groups:0.1 mg/kg of Dezocine combined with midazolam（group D1）;0.15 mg/kg of Dezocine combined with Midazolam（group D2）;0.2mg/kg of Dezocine combined with Midazolam（group D3）,with 20 cases in each group.VAS scores and Ramsay scores were adopted to evaluate the analgesic and sedative effects.MAP,HR,and SpO₂ were recorded before drug delivery（T₀）,15 minutes after drug delivery（T₁）,15 minutes after focused treatment（T₂）,at the end of the treatment（T₃）,and 2 hours after treatment（T₄）.VAS scores and Ramsay scores,the incidence rates of abdominal pain at the end of operation and adverse effects were recorded. Results Compared with group D1,the MAP and HR of group D3 clearly reduced at stages of T₁,T₂,and T₃（P<0.05）;Compared with T₁,the MAP and HR of group D1 at stage T₂ clearly increased（ P<0.05）;There was no significant difference of MAP and HR in each stage in group D2（ P>0.05）.Compared with group D1,the VAS scores were lower and Ramsay scores were higher in group D3（ P<0.05）.There was no significant difference in the VAS scores and the Ramsay scores between group D2 and D3（ P> 0.05）.The incidence rates of abdominal pain at the end of operation in group D1 and adverse effects in group D3 were higher than those of group D2（P <0.05）.Conclusion Intravenous anesthesia of 0.15 mg/kg of Dezocine combined with Midazolam can provide good analgesic and sedative effect for high-intensity focused ultrasound to ablate hysteromyoma that can be clinically applied with safety.更多还原