实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2014年
12期
46-48,50
,共4页
阿曲库铵%麻醉%药效学%肝硬化
阿麯庫銨%痳醉%藥效學%肝硬化
아곡고안%마취%약효학%간경화
atracurium%anesthesia%pharmacodynamics%liver cirrhosis
目的：探讨非去极化肌松药阿曲库铵用于肝硬化麻醉的肌松效应和安全性。方法将12例肝硬化行脾切除手术患者随机分为A、B组，12例行胃大部分切除术患者随机分为C、D组，每组6例。 A、C组采用阿曲库铵2倍ED95（0.4 mg·kg-1）麻醉， B、D组采用阿曲库铵3倍ED95（0.6 mg·kg-1）麻醉。观察各组麻醉诱导前后生命体征的变化、插管条件及肌松效应。结果各组插管前后血流动力学均无明显改变（P>0.05）；A、C组插管条件优率明显低于B、D组（P<0.05）；A、C组起效时间较B、D组明显减慢，T195%恢复时间、4个成串刺激（TOF）比值恢复到70%的时间（T4/T1≥0.7）较B、D组明显缩短，差异均有统计学意义（P<0.05）。结论阿曲库铵可以安全用于肝硬化患者的麻醉，3倍ED95剂量比2倍ED95剂量的起效更快。
目的：探討非去極化肌鬆藥阿麯庫銨用于肝硬化痳醉的肌鬆效應和安全性。方法將12例肝硬化行脾切除手術患者隨機分為A、B組，12例行胃大部分切除術患者隨機分為C、D組，每組6例。 A、C組採用阿麯庫銨2倍ED95（0.4 mg·kg-1）痳醉， B、D組採用阿麯庫銨3倍ED95（0.6 mg·kg-1）痳醉。觀察各組痳醉誘導前後生命體徵的變化、插管條件及肌鬆效應。結果各組插管前後血流動力學均無明顯改變（P>0.05）；A、C組插管條件優率明顯低于B、D組（P<0.05）；A、C組起效時間較B、D組明顯減慢，T195%恢複時間、4箇成串刺激（TOF）比值恢複到70%的時間（T4/T1≥0.7）較B、D組明顯縮短，差異均有統計學意義（P<0.05）。結論阿麯庫銨可以安全用于肝硬化患者的痳醉，3倍ED95劑量比2倍ED95劑量的起效更快。
목적：탐토비거겁화기송약아곡고안용우간경화마취적기송효응화안전성。방법장12례간경화행비절제수술환자수궤분위A、B조，12례행위대부분절제술환자수궤분위C、D조，매조6례。 A、C조채용아곡고안2배ED95（0.4 mg·kg-1）마취， B、D조채용아곡고안3배ED95（0.6 mg·kg-1）마취。관찰각조마취유도전후생명체정적변화、삽관조건급기송효응。결과각조삽관전후혈류동역학균무명현개변（P>0.05）；A、C조삽관조건우솔명현저우B、D조（P<0.05）；A、C조기효시간교B、D조명현감만，T195%회복시간、4개성천자격（TOF）비치회복도70%적시간（T4/T1≥0.7）교B、D조명현축단，차이균유통계학의의（P<0.05）。결론아곡고안가이안전용우간경화환자적마취，3배ED95제량비2배ED95제량적기효경쾌。
Objective To investigate the efficacy and safety of nondepolarizing muscle relaxant atracurium in patients with liver cirrhosis. Methods Twelve liver cirrhosis patients scheduled for splenectomy were randomly divided into group A and group B, with 6 patients in each group. In addition, 12 patients scheduled for subtotal gastrectomy were randomly divided into group C and group D, with 6 patients in each group. Patients in group A and C received 2 × ED95 atracurium (0.4 mg·kg-1). However, patients in group B and D received 3 × ED95 atracurium (0.6 mg·kg-1). The vital signs were observed before and after anesthesia induction. The tracheal intubating conditions and muscle relaxant effects were measured in all patients. Results No obvious changes in the hemodynamics were found after intubation in all groups(P>0.05). The rate of optimal tracheal intubating conditions in group A or C was significantly lower than that in group B or D(P<0.05). The onset time in group A or C was signi-ficantly longer than that in group B or D(P<0.05). However, the time to 95% recovery of T1 and time to recovery of train-of-four (TOF) ratio to 70%(T4/T1≥0.7) in group A or C were significantly shorter than those in group B or D(P<0.05). Conclusion Atracurium can be used safely in patients with liver cirr-hosis, and the dose of 3 × ED95 has a faster onset than that of 2 × ED95.
