甲苯磺酸瑞马唑仑在胆管癌无痛ERCP中的应用效果  

Application of Remimazolam Tosilate in Cholangiocarcinoma Patients with Painless Endoscopic Retrograde Cholangiopancreatography

作　　者：杨建功[1] 赵利芳[1] 王培山[1] 孟瑞霞[1] 王开娟[1] 巩继平[1] 代秀 YANG Jiangong;ZHAO Lifang;WANG Peishan(Xinxiang Central Hospital,Xinxiang,453000)

机构地区：[1]河南省新乡市中心医院,453000

出　　处：《实用癌症杂志》2022年第6期959-962,1002,共5页The Practical Journal of Cancer

基　　金：河南省科技攻关项目[编号:2020-099-01(K)]。

摘　　要：目的 探讨甲苯磺酸瑞马唑仑在胆管癌患者行无痛内镜逆行胰胆管造影术(ERCP)中的应用效果。方法 选取行无痛ERCP的97例胆管癌患者,采用抽签法将患者随机分为对照组48例与实验组49例。对照组行丙泊酚复合瑞芬太尼麻醉,实验组行甲苯磺酸瑞马唑仑复合瑞芬太尼麻醉。比较两组血流动力学指标变化、镇静效果、麻醉相关指标及不良反应发生率。结果 手术开始后两组心率、平均动脉压、血氧饱和度均有不同程度波动,且实验组波动程度小于对照组(P<0.05)。手术开始后两组Ramsay评分显著上升(P<0.05),且实验组上升程度低于对照组(P<0.05)。药物起效时间实验组短于对照组(P<0.05)。实验组苏醒时间与离室时间短于对照组(P<0.05)。实验组与对照组相比,低氧血症、低血压发生率低(P<0.05),恶心、呕吐、头晕、体动、呃逆、呛咳等发生率无显著差异(P>0.05)。结论 甲苯磺酸瑞马唑仑复合瑞芬太尼在胆管癌患者行无痛ERCP中能稳定血流动力学指标,快速达到手术镇静条件,操作期间无显著不良反应发生,推荐临床使用。Objective To investigate the effect of remimazolam tosilate in cholangiocarcinoma patients with painless endoscopic retrograde cholangiopancreatography(ERCP).Methods 97 patients with cholangiocarcinoma underwent painless ERCP were enrolled,and randomly divided into 2 groups.The control group(n=48) received propofol combined with remifentanil anesthesia,and the experimental group(n=49) received remimazolam tosilate combined with remifentanil anesthesia.Then the hemodynamic indexes,sedative effect,anesthesia related indexes and adverse reaction rate were compared.Results After operation,heart rate,mean arterial pressure and oxygen saturation in both groups fluctuated to different degrees,and the fluctuation degree in experimental group was less than that in control group(P<0.05).There was an increase in Ramsay score in both groups after operation(P<0.05),and the score showed no significant difference between groups(P>0.05).The onset of anaesthesia had no significant difference between groups(P>0.05).The time to awaken from anaesthesia and the time to leave the room were all shorter in experimental group than in the control group(P<0.05).The incidence of hypoxaemia,hypotension and nausea,vomiting and dizziness were lower in experimental group than in the control group(P<0.05).Conclusion Application of remimazolam tosilate combined with remifentanil in patients with cholangiocarcinoma undergoing painless ERCP can effectively stabilize hemodynamic indexes and quickly achieve surgical sedation with no significant adverse reactions,so it is recommended for clinical use.

关 键 词：甲苯磺酸瑞马唑仑 内镜逆行胰胆管造影术 麻醉效果 

分 类 号：R735.8[医药卫生—肿瘤]