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目的：比较咪唑安定和丙泊酚分别复合舒芬太尼用于B 超引导下经皮肝穿刺射频消融术（PRFA)的麻醉效果。方法：选择 2011 年7 月至2013 年5 月需行PRFA 肝癌患者60 例，随机分成丙泊酚组和咪达唑仑组各30 例，分别复合舒芬太尼静注行全身麻醉。记录麻醉前（T0）、麻醉后5分钟（T1）、手术开始时(T2)，手术开始后5 分钟(T3)，15 分钟(T4)，手术结束时(T5)的平均动脉压 (MAP)、心率(HR)和血氧饱和度(SpO2)。记录两组患者苏醒时间和定向力恢复时间，并进行术后6 小时、12 小时、24 小时视觉模糊评分（VAS）。结果：丙泊酚组T1 时的MAP 明显低于麻醉前（P<0.05），且明显低于咪达唑仑组（P<0.05），两组患者T1 时的HR明显低于麻醉前（P<0.05），丙泊酚组患者T1 时的SpO2明显低于麻醉前（P<0.05）。咪达唑仑组苏醒时间明显短于丙泊酚组，咪达唑仑组术后6 小时VAS 评分明显低于丙泊酚组（P<0.05）。结论：与丙泊酚比较，咪达唑仑复合舒芬太尼静脉全麻具有对循环影响小、苏醒迅速，患者舒适无痛等优点，是较为合适的麻醉方式。

英文摘要:

Objective:To compare the anesthesia effects of midazolam and propofol respectively combined with sulfentanyl in Percutaneous radiofrequency ablution （PRFA）guided byB ultrasound.Methods:A total of 60 patient with liver cancer, who were given PRFA in Nongken General Hospital of Hainan Province fromJuly 2011 to May 2013, were randomly divided into propofol group( n=30) and midazolam group ( n=30 ), respectively combined with sulfentanyl intravenous infusion for general anesthesia, separately recording MAP, HR and SpO2 before anesthesia(T0), 5 minutes after anesthesia(T1), at the beginning of operation (T2), 5 minutes after operation (T3), 15 minutes after operation (T4) and at the end of operation (T5), and awakening time, recovery time of orientation of the two groups, and then evaluating the VAS scores 6 hours, 12 hours, 24 hours after of operation.Results:MAP of propofol group 5 minutes after anesthesia was significantly lower than that before anesthesia (P<0.05), and lower than that of midazolam group(P<0.05); HR of the two groups 5 minutes after anesthesia was significantly lower than that before anesthesia (P<0.05); SpO2 of propofol group 5 minutes after anesthesia was significantly lower than that before anesthesia (P<0.05). Awakening time of midazolam group was obviously shorter than that of propofol group, and the VAS score of midazolam group 6 hours after operation was significantly lower than that of propofol group (P<0.05).Conclusion:Compared with propofol, midazolam combined with sulfentanyl intravenous infusion for general anesthesia has the advantages of less impact on the circulation, quickly awakening, confort and no pain, which is more suitable anesthesia in the treatment of patients with liver cancer.

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