摘要
目的探讨原发性肝癌（HCC）患者行动脉化疗栓塞（TACE）术前应用镇静药物的效果及安全性。方法156例HCC患者均为首次接受TACE治疗，随机分为四组。空白组30例，TACE术前肌注生理盐水10ml；地西泮组42例，TACE术前肌注地西泮10mg；异丙嗪组42例，TACE术前肌注异丙嗪25mg；联合组42例，TACE术前肌注地西泮10mg及异丙嗪25mg。观察四组患者术中镇静、不良感觉及焦虑等情况。结果收缩压差及心率差：空白组明显高于其他三组，差异有统计学意义；地西泮组与异丙嗪组差异无统计学意义；而联合组与地西泮组或异丙嗪组比较差异均有统计学意义。镇静评价：0级患者空白组、地西泮组、异丙嗪组、联合组分别为30例、11例、18例、0例；1级患者空白组、地西泮组、异丙嗪组、联合组分别为0例、21例、15例、24例；2级患者空白组、地西泮组、异丙嗪组、联合组分别为0例、10例、9例、18例；四组无3、4级病例。焦虑值：空白组明显高于其他三组，差异均有统计学意义；地西泮组、异丙嗪组和联合组三组问差异无统计学意义。四组患者不良感觉的发生率差异无统计学意义。结论TACE术前肌注地西泮联合异丙嗪能够有效的镇静，降低患者术中的应激反应及焦虑情绪，提高患者对TACE手术的耐受性。
Objective To investigate the efficacy and safety of using various sedative regimens du- ring transcatheter arterial chemoembolization （TACE） for hepatocellular carcinoma （HCC）. Methods 156 HCC patients were randomly divided into four groups. The control group （n = 30） ： intramuscular injection of 10 ml saline; The diazepam group （n = 42） ： intramuscular injection of 10 mg of diazepam; The prometha- zine group （ n = 42 ） ： intramuscular injection of promethazine 25 mg ; and The combined group （ n = 42 ） ： intramuscular injection of 10 mg of diazepam and promethazine 25 mg. Results The blood pressure and heart rate of the control group was significantly higher than the other three groups, while the combined group was significantly lower than the diazepam and the promethazine groups. The sedative rating： Grade 0 of the four groups were： 30, 11, 18, 0 patients respectively; Grade 1 of the four groups were： 0, 21, 15, 24 pa- tients respecfively ; Grade 2 of the four groups were ： 0, 10, 9, 18 patients respectively ; No patients were in grades 3 and 4. The anxiety score of the control group was significantly higher than the other three groups. There was no significant difference in complications among the four groups. Conclusion Diazepam and/or promethazine could be used effectively and safely during TACE, and they could reduce stress response of HCC patients during TACE, and improved tolerance of TACE.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2015年第7期454-457,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
原发性肝癌
动脉化疗栓塞
地西泮
异丙嗪
Hepatocellular carcinoma
Transcatheter arterial chemoembolization
Diazepam
Promethazine
