【摘要】 目的 研究瑞马唑仑联合布托啡诺用于宫腔镜诊刮术中的安全性及有效性。方法 选择荆门市第一人民医院行宫腔镜诊刮术的患者,按照随机数表法分为丙泊酚+布托啡诺组（P+B组）,瑞马唑仑+布托啡诺组（R+B组）,每组各50例。记录两组患者诱导前（T₀）、意识消失时（T₁）、宫颈扩张时（T₂）、意识清醒时（T₃）的心率及平均动脉压的变化,比较两组患者诱导注射痛、呼吸抑制、术后头晕、恶心、呕吐等不良反应发生情况,记录患者停药后的苏醒时间。结果 R+B组在T₁和T₂时刻的心率（heart rate,HR）显著高于P+B组;R+B组在T₁和T₃时刻的平均动脉压（mean arterial pressure,MAP）显著高于P+B组（P<0.05）。P+B组和R+B组分别组内4个时间点HR比较差异无统计学意义（P>0.05）。与T₀比较,P+B组T₁～T₃时刻的MAP均显著降低,R+B组在T₁时刻的MAP均显著降低（P<0.05）。两组组内其他时间点MAP差异无统计学意义（P>0.05）。与P+B组相比,R+B组的注射痛、呼吸抑制以及低血压的发生率显著降低（P<0.05）。两组患者苏醒时间差异无统计学意义（P>0.05）。结论 瑞马唑仑联合布托啡诺用于宫腔镜诊刮术,血流动力学平稳,呼吸抑制发生率低,不良反应发生少,麻醉效果及安全性佳。更多还原

【Abstract】 Objective To study the safety and effectiveness of remimazolam combined with butorphanol in hysteroscopy.Methods The patients who underwent hysteroscopic surgery in our hospital were randomly divided into propofol+butorphanol group（P+B group）and remimazolam+butorphanol group（R+B group）with 50 patients in each group.The changes of heart rate and mean arterial pressure before induction（T₀）,at the time of loss of consciousness（T₁）,at the time of cervical dilatation（T₂）,and at the time of conscious awakening（T₃）were recorded in the two groups.The adverse reactions such as induced injection pain,respiratory inhibition,postoperative dizziness,nausea,and vomiting in the two groups were compared.The time of recovery after drug withdrawal was recorded.Results HR of R+B group at T₁ and T₂ was significantly higher than that of P+B group;MAP of R+B group at T₁ and T₃ was significantly higher than that of P+B group（P<0.05）.There was no significant difference in HR between P+B group and R+B group at four time points（P>0.05）.Compared with T₀,the MAP of P+B group at T₁-T₃ was significantly lower,and that of R+B group at T₁ was significantly lower（P<0.05）.There was no significant difference in MAP between the two groups at other time points（P>0.05）.Compared with P+B group,the incidence of injection pain,respiratory depression and hypotension in R+B group were significantly lower（P <0.05）.There was no significant difference between the two groups in recovery time（P >0.05）.Conclusions Remimazolam combined with butorphanol in hysteroscopy has stable hemodynamics,low incidence of respiratory depression,less adverse reactions,good anesthetic effect and safety.更多还原