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目的:比较咪唑安定和丙泊酚分别复合舒芬太尼用于B超引导下经皮肝穿刺射频消融术(PRFA)的麻醉效果。方法:选择2011年7月至2013年5月需行PRFA肝癌患者60例,随机分成丙泊酚组和咪达唑仑组各30例,分别复合舒芬太尼静注行全身麻醉。记录麻醉前(T0)、麻醉后5分钟(T1)、手术开始时(T2),手术开始后5分钟(T3),15分钟(T4),手术结束时(T5)的平均动脉压(MAP)、心率(HR)和血氧饱和度(Sp O2)。记录两组患者苏醒时间和定向力恢复时间,并进行术后6小时、12小时、24小时视觉模糊评分(VAS)。结果:丙泊酚组T1时的MAP明显低于麻醉前(P<0.05),且明显低于咪达唑仑组(P<0.05),两组患者T1时的HR明显低于麻醉前(P<0.05),丙泊酚组患者T1时的Sp O2明显低于麻醉前(P<0.05)。咪达唑仑组苏醒时间明显短于丙泊酚组,咪达唑仑组术后6小时VAS评分明显低于丙泊酚组(P<0.05)。结论:与丙泊酚比较,咪达唑仑复合舒芬太尼静脉全麻具有对循环影响小、苏醒迅速,患者舒适无痛等优点,是较为合适的麻醉方式。
OBJECTIVE: To compare the anesthetic effects of midazolam and propofol combined with sufentanil for percutaneous transhepatic liver biopsy (PRFA) under ultrasound guidance. Methods: From July 2011 to May 2013, 60 patients with PRFA hepatocellular carcinoma were randomly divided into propofol group and midazolam group, with 30 cases in each group. All patients were given sufentanil intravenously for general anesthesia. The mean arterial pressure (MAP) was recorded before anesthesia (T0), 5 minutes after anesthesia (T1), at the start of surgery (T2), 5 minutes after the start of surgery (T3), 15 minutes (T4) , Heart rate (HR) and oxygen saturation (Sp O2). The recovery time of waking time and recovery time of the two groups were recorded, and visual acuity score (VAS) of 6 hours, 12 hours and 24 hours after operation were recorded. Results: The MAP at T1 in propofol group was significantly lower than that before anesthesia (P <0.05) and significantly lower than that in midazolam group (P <0.05) <0.05). SpO2 in T1 group was lower than that before anesthesia in propofol group (P <0.05). The awake time of midazolam group was significantly shorter than that of propofol group. The VAS score of midazolam group 6 hours after operation was significantly lower than that of propofol group (P <0.05). Conclusion: Compared with propofol, midazolam combined with sufentanil intravenous general anesthesia has little effect on circulation, rapid recovery, patients comfortable and painless, is a more appropriate anesthesia.