咪达唑仑对儿童患者焦虑水平及皮质醇影响的初步研究

Effects of Midazolam on Children's Anxiety and Cortisol Level

目的：研究在鼻内和舌下使用咪达唑仑对儿童患者焦虑水平和唾液皮质醇水平的影响,探讨温和镇静剂用于儿童口腔科的可能性。方法：选择2015年3月-2016年2月于我院就诊3-7岁儿童患者82例。将患者随机分为2组,分别于口腔治疗前30min通过鼻内、舌下途径使用咪达唑仑。常规进行口腔治疗,每5min记录1次Venham分级。并在用药前与用药30min后收集唾液,测定唾液皮质醇水平。结果：2组不同时间点（T1、T2、T3、T4）与T0时相比,患儿的焦虑情况均显著改善（P〈0.05）。T1、T2时舌下组患儿的焦虑缓解情况较鼻内组效果更好（P〈0.05）。而两组唾液皮质醇水平在服药前后均没有显著差异。结论：咪达唑仑可以有效缓解儿童患者焦虑,舌下途径给药比鼻内途径吸收更好,对唾液皮质醇水平无影响。

Objective：To investigate the effects of midazolam on anxiety levels and salivary cortisol levels in children after intranasal and sublingual midazolam,and to explore the possibility of mild sedation in Department of Pediatric Stomatology.Methods：Eighty-two patients with 3-7years old were included in this study and were randomly divided into two groups.Patients received intranasal or sublingual midazolam at the 30 minutes prior to oral treatment.The anxiety levels were assessed using Venham clinical anxiety scale per 5minutes and salivary cortisol levels were assessed 30 minutes before and after administration.Results：There was a significant decrease in the anxiety level from T0 to T1-T4 in group A and group B（P〈0.05）.There was no significant difference between two groups in the levels of salivary cortisol before and after taking the medicine.Conclusion：Midazolam can effectively relieve anxiety in children patients and has no effect on salivary cortisol levels.The tongue way was better absorption than the nasal route.