CAJ | 학술논문

目的：观察不同剂量罗库溴铵麻醉对甲状腺手术患者术中喉返神经监测的影响。方法选择87例行甲状腺手术治疗的患者，分为按照罗库溴铵使用剂量的不同分为三组，其中 A 组0.3 mg/ kg、B 组0.6 mg/ kg、C 组0.9 mg/kg。观察并记录三组患者给药前、给药后90 s 以及插管后90 s 血压和心率的变化。监测并记录给予肌松药到开始神经检测需要的时间，并观察三组术中神经监测情况。结果三组患者给药后血压、心率均出现明显下降。A 组插管后血压明显上升，与给药前相比有统计学差异。B 组、C 组插管后血压、心率均显著低于 A 组患者。C 组患者未及时检测到喉返神经的病例数（17例）显著高于 B 组（4例）和 A 组（0例），C 组未及时监测到的病例需等待时间（19.4±2.0 min）显著高于 A（0）和 B 组（5.4±1.1 min），A 组术中出现体动的病例数（8例）显著高于 B 组（0例）和 C 组（0例）。结论甲状腺手术中应用0.6 mg/ kg 罗库溴铵既可满足麻醉诱导与手术需要，也不影响术中喉返神经监测，值得临床推广应用。
목적：관찰불동제량라고추안마취대갑상선수술환자술중후반신경감측적영향。방법선택87례행갑상선수술치료적환자，분위안조라고추안사용제량적불동분위삼조，기중 A 조0.3 mg/ kg、B 조0.6 mg/ kg、C 조0.9 mg/kg。관찰병기록삼조환자급약전、급약후90 s 이급삽관후90 s 혈압화심솔적변화。감측병기록급여기송약도개시신경검측수요적시간，병관찰삼조술중신경감측정황。결과삼조환자급약후혈압、심솔균출현명현하강。A 조삽관후혈압명현상승，여급약전상비유통계학차이。B 조、C 조삽관후혈압、심솔균현저저우 A 조환자。C 조환자미급시검측도후반신경적병례수（17례）현저고우 B 조（4례）화 A 조（0례），C 조미급시감측도적병례수등대시간（19.4±2.0 min）현저고우 A（0）화 B 조（5.4±1.1 min），A 조술중출현체동적병례수（8례）현저고우 B 조（0례）화 C 조（0례）。결론갑상선수술중응용0.6 mg/ kg 라고추안기가만족마취유도여수술수요，야불영향술중후반신경감측，치득림상추엄응용。
Objective To investigate the different doses of rocuronium anesthesia on monitoring recurrent laryngeal nerve in patients un-dergoing thyroid surgery. Methods Eighty - seven patients with routine thyroid surgery were collected and divided according to different doses of rocuronium into group A(0. 3 mg/ kg),group B(0. 6 mg/ kg),and group C(0. 9 mg/ kg). Blood pressure and heart rate changes were observed and recorded before administration,90 s after administration and 90 s after intubation in the three groups. The time from given muscle relaxants to begin nerve testing was monitored and recorded and intraoperative nerve monitoring in the three groups was observed. Results In three groups of patients,blood pressure and heart rate were apparent declined after administration. Blood pressure in group A after intubation was increased signif-icantly,with significant differences to the previous. Blood pressure and heart rate in group B and group C after cannulation were significantly lower than group A. The number of cases in whom the recurrent laryngeal nerve couldn′t be detected in time in group C(17 cases)was significantly high-er than that of group B(4 cases)and group A(0 case). The time waited for the start of recurrent laryngeal nerve monitoring in group C(19. 4 ± 2. 0 min)was significantly higher than that in group A(0)and group B(5. 4 ± 1. 1 min). In group A,number of intraoperative body movement (8 cases)was significantly higher than in group B(0 case)and group C(0 case). Conclusion 0. 6 mg/ kg rocuronium can meet the needs of anesthesia and surgery,and this dosage does not affect intraoperative recurrent laryngeal nerve monitoring.