地西泮和咪哒唑仑在结肠镜检查中的联合应用

Feasibility of the combined use of diazepam and midazolam in proctocolonoscopy

目的:观察结肠镜检查中联合应用地西泮和咪哒唑仑的镇静效果、安全性和患者的满意度。方法:889例行结肠镜检查的患者,随机分为镇静组(482例)和对照组(407例),镇静组患者检查前10min依次静脉注射盐酸曲他维林、地西泮、咪哒唑仑注射液,进入睡眠状态时即进行肠镜操作,对照组患者静脉注射盐酸曲他维林注射液后直接进行操作,分别观察记录血压、脉搏、血氧饱和度,记录是否到达回盲部及完成检查所用时间,检查结束待患者清醒后询问患者遗忘程度和满意度以了解病人对检查的评价。结果:镇静组检查前后血压、脉搏、血氧饱和度变化不明显(P>0.05),对照组检查结束后血压较检查前升高、脉搏加快,血氧饱和度检查前后无明显变化;镇静组到达回盲部检查成功率较对照组高,完成检查所用时间较对照组短(P<0.05);镇静组患者遗忘程度和满意度较对照组高(P<0.01)。结论:结肠镜检查时联合应用地西泮和咪哒唑仑具有效果确切、安全高效、患者满意等特点。

Objective To investigate the feasibility of the combined use of diazepam and midazolam in proctocolonoscopy. Methods Eight hundred and eighty-nine patients undergoing proctocolonoscopy were randomly divided into control group （n = 407） and sedation group （n = 482）. Patients in sedation group were intravenously injected slowly with diazepam and midazolam by rums before proctocolonoscopy up to falling asleep （unconscious status）. Patients without sedation was taken as control group. Changes of the blood pressure （BP）, pulse（P） and blood oxygen saturation （SpO2） of patients in both groups were observed. Proceeding times and success rate were recorded. After the procedures and the consciousness, the patients were asked and recorded about the feeling, amnesia, satisfaction and so on. Results From the beginning to the end of proctocolonoscopy, there were no remarkable changes of the level of BP, P and SpO2 in sedation group （P 〉 0.05）. At the end of proctocolonoscopy, the levels of BP, P were higher than those at the beginning of proetocolonoscopy in control group, SpO2 had no change. The proceeding times of sedation group were shorter than those in control group while the success rate was higher than that in control group （P 〈 0.01）. Conclusion The combined use of diazepam and midazolam in proctocclonoscopy is effective, safe and higher satisfactive rate.