咪达唑仑应用于认知功能障碍患者腰椎穿刺检查的镇静效果观察

The sedative efficacy of Midazolam on patients with cognitive impairment in lumber puncture

目的观察咪达唑仑在有认知功能障碍患者腰椎穿刺检查中的临床应用效果和安全性。方法将49例存在认知功能障碍并有腰椎穿刺指证的患者随机分为2组,分别应用靶控静脉泵入咪达唑仑(咪达唑仑组)和持续人为安抚制动(对照组)的方法下实施腰椎穿刺检查,比较2组间腰椎穿刺检查的完成率、检查中躁动发生率、检查后平卧4 h配合率及检查完成时间,同时动态观察记录咪达唑仑组用药前、检查中及检查后的心率、呼吸频率、血压及血氧饱和度变化情况。结果 2组患者腰椎穿刺检查完成率、检查中躁动发生率、检查后4h平卧率及完成时间均有显著性差异(P<0.01),咪达唑仑组用药前、检查中及检查后的心率、舒张压、呼吸频率及血氧饱和度无显著差异(P>0.05),收缩压下降明显(P<0.05),但波动于正常参考值范围内。结论咪达唑仑用于腰椎穿刺的镇静治疗安全有效,可作为伴有认知功能障碍患者检查时的用药选择。

Objective To evaluate the sedative efficacy of Midazolam on patients with cognitive impairment in lumber puncture （LP）. Methods 49 patients with cognitive impairment were randomly divided into two groups： 25 patients were punctured under Midazolam sedation （Midazolam group）, the other 24 patients were punctured under comfort and contral （control group）. Compared the completion rate and cooperation rate of these two group , analysis the changes of patient physiological parameters including heart rate（HR）, respiratory rate（RR）,systolic blood pressure（SBP）, diastolic blood pressure（DBP） and oxygen saturation（SpO2）of Midazolam group before, during and after the LP. Results There were significant difference in the rates of completion and cooperation between the two groups （P〈0. 01）. For Midazolam group, no significant difference in the DBP, HR,RR and SpO2 were observed before, during and after the LP（P〈0. 05）, except in SBP （P〈0. 05）. Conclusions For patients with cognitive impairmen, Midazolam is effectively and safely in lumber puncture.