静脉泵入咪达唑仑清醒镇静技术控制牙科恐惧症的临床效果评价

Continuous intravenous infusion of midazolam:A clinical study of conscious sedation for dental phobia

目的评价静脉泵入咪达唑仑控制牙科恐惧症的临床效果。方法选择31例对牙科治疗极度恐惧但能与医师良好沟通的患者,将其两侧需行根管治疗的2颗患牙分别纳入试验组和对照组,对照组为常规牙科治疗,试验组加用咪达唑仑静脉泵入清醒镇静技术,控制患者治疗过程中的恐惧。评价两组患者的治疗依从性和行为治疗效果,并观察试验组患者生命体征的变化及副作用的发生率。结果试验组、对照组的Houpt行为治疗效果评分和Frankl治疗依从性评分均存在显著性差异(z=-4.846,P=0.000;z=-4.907,P=0.000)。试验组患者采用镇静措施后血压、心率均有轻度降低,并有轻度的呼吸抑制,但不影响治疗完成。结论单纯咪达唑仑静脉镇静对于能够良好沟通、主观愿意配合的极度牙科恐惧患者具有较好的疗效。

Objective To evaluate the sedative effect of continuous intravenous infusion of midazolam in treating severe dental phobia. Methods 31 patients with severe dental phobia were enrolled and all of them had good com- munication with dentists. Two teeth in each patient were assigned to control group and experiment group seperately. The control group received root canal therapy. The experiment group were sedated by intravenous midazolam and received root canal therapy. The treat dependence and behavior therapy efficacy were evaluated. The vital signs and side effects during treatment were noted. Results Continuous intravenous infusion of midazolam showed a significant good sedative effect on patients with severe dental phobia. There were statistical difference in the Houpt score and the Frankl score between experiment group and control group （z=-4.846, P=0.000; z=-4.907, P=0.000）. The total dose of midazolam was （9.58±3.76） mg, and mean infusion rate was （0.28±0.06） mg·kg^-1·h^-1. The blood pressure, heart rate and respiration of experiment group were depressed. But these changes didn＇t interfere with the completion of the whole treatment. No severe side effects were detected. Conclusion The single use of midazolam as an intravenous sedation agent has satisfactory effect on patients with severe dental phobia.