目的 探讨小剂量咪唑安定复合芬太尼在冠状动脉介入术中对患者的镇静镇痛作用和术中护理要点.方法 将410例拟行冠状动脉介入术的冠状动脉性心脏病患者随机双盲均分为两组,对照组仅用局部麻醉药,观察组在对照组给药的基础上另予咪唑安定1mg和芬太尼50μg.分别观察两组患者术前、穿刺时、造影结束后即刻、造影结束后120min的心率、血压、血氧饱和度,记录镇痛评分、镇静评分、焦虑评分和护理干预对策.结果 观察组镇静评分、焦虑评分明显优于对照组,生命体征较对照组明显平稳(P<0.01).结论 应用小剂量咪唑安定复合芬太尼镇静,在冠状动脉介入术中能取得满意效果,患者痛苦小、安全可靠;密切的护理配合、通畅的静脉通道以及生命体征监护对于保证手术成功非常重要.%Objective To investigate the effect of sedation and analgesia of low dose midazolam with fentanyl in coronary angiography(CAG) and to study the nursing main points during operation. Methods Four hundred and ten patients preparing to undergo CAG were randomly divided into 2 groups by double blind method; 1 mg midazolam +50 μg fentanyl were administered in therapy group (n =205) and only narcotic was administered in control group (n =205). HR, blood pressure and oxygen saturation were observed before, during, immediately after and 120 min after CAG, and Prine Henry Scale(PHS), Visual Analogue Scale (VAS), five -point scale assessment of sedation level as well as nursing intervention were recorded at the same time. Results The scores of sedation and VAS during CAG were better in therapy group than in control group. Vital signs stability was better in therapy group than in control group. Conclusion The administration of low dose midazolam with fentanyl during CAG could offer the satisfying sedation effects with safety, reliability and less pain for the patients. It is important for a successful CAG to provide close nursing cooperation and observation of vital signs.
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