CAJ | 학술논문

目的比较布依族与汉族患者罗库溴铵的肌松时效.方法择期全麻下行腔镜或关节镜手术患者60例,性别不限,年龄20 ～ 55岁,体重指数18～25 kg/m,ASA分级Ⅰ或Ⅱ级,按民族分为2组(n=30):汉族组(H组)和布依族组(B组).静脉注射咪达唑仑和芬太尼,靶控输注异丙酚行麻醉诱导.待患者意识消失后进行肌松定标,采用加速度仪单个刺激模式,肌颤搐达最大抑制时静脉注射罗库溴铵0.6 mg/kg,气管插管行机械通气,维持PETCO2 30～35 mm Hg.记录肌松起效时间、无反应期、临床作用时间、75％恢复时间和恢复指数.采用ELISA法测定血浆α1-酸性糖蛋白浓度,采用生化法测定血浆白蛋白浓度.结果与H组比较,B组肌松起效时间延长,血浆α1-酸性糖蛋白浓度降低(P＜0.05),无反应期、临床作用时间、75％恢复时间、恢复指数和血浆白蛋白浓度差异无统计学意义(P＞0.05).结论布依族患者较汉族患者罗库溴铵肌松起效慢,可能与布依族患者血浆α1-酸性糖蛋白浓度较低有关.
목적 비교포의족여한족환자라고추안적기송시효.방법 택기전마하행강경혹관절경수술환자60례,성별불한,년령20 ～ 55세,체중지수18～25 kg/m,ASA분급Ⅰ혹Ⅱ급,안민족분위2조(n=30):한족조(H조)화포의족조(B조).정맥주사미체서륜화분태니,파공수주이병분행마취유도.대환자의식소실후진행기송정표,채용가속도의단개자격모식,기전휵체최대억제시정맥주사라고추안0.6 mg/kg,기관삽관행궤계통기,유지PETCO2 30～35 mm Hg.기록기송기효시간、무반응기、림상작용시간、75％회복시간화회복지수.채용ELISA법측정혈장α1-산성당단백농도,채용생화법측정혈장백단백농도.결과 여H조비교,B조기송기효시간연장,혈장α1-산성당단백농도강저(P＜0.05),무반응기、림상작용시간、75％회복시간、회복지수화혈장백단백농도차이무통계학의의(P＞0.05).결론 포의족환자교한족환자라고추안기송기효만,가능여포의족환자혈장α1-산성당단백농도교저유관.
Objective To determine whether there is any difference in rocuronium-induced muscle relaxation between patients of Buyi and Han nationality.Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes aged 20-55 yr,with body mass index of 20-25 kg/m2,undergoing laparoscopic or arthroscopic surgery under general anesthesia,were divided into 2 groups ( n =30 each):Han group (group H) and Buyi group (group B).Anesthesia was induced with midazolam,fentanyl and TCI of propofol (Cp=2-3 μg/ml).Tracheal intubation was facilitated with rocuronium 0.6 mg/kg.The patients were mechanically ventilated.PETCO2 was maintained at 30-35 mm Hg.Neuro-muscular (N-M) function was monitored by accelerography.N-M block was assessed by single stimulation of ulna nerve after loss of consciousness.The onset time,maximal N-M block time,clinical muscle relaxation time (from injection d rocuronium to 25％ recovery),75％ recovery time (from injection of rocuronium to 75％ recovery) and recovery index were recorded.The plasma concentration of albumin and α1-acid glycoprotein were measured by ELISA and biochemical analysis respectively.Results The onset time was significantly longer and plasma α1-acid glycoprotein concentration lower in group B than in group H.There was no significant difference in maximal N-M block time,clinical muscle relaxation time,75％ recovery time,recovery index and plasma albumin concentration between the 2 groups.Conclusion The onset time of rocuronium-induced N-M block is longer in patients of Buyi nationality as compared with patients of Han nationality.Lower plasma α1 -acid.glycoprotein concentration may be involved in the underlying mechanism.