顺阿曲库铵不同给药方式在肾移植术中的应用研究

doi:10.3760/cma.j.issn.1007-1245.2023.16.013

国际医药卫生导报 ›› 2023, Vol. 29 ›› Issue (16): 2277-2280.DOI: 10.3760/cma.j.issn.1007-1245.2023.16.013

顺阿曲库铵不同给药方式在肾移植术中的应用研究

邓群姜晶晶

郑州市第七人民医院麻醉科，郑州　450000

收稿日期:2023-01-19 出版日期:2023-08-15 发布日期:2023-08-29
通讯作者: 邓群，Email：dengquniu@163.com
基金资助:
河南省医学科技攻关项目（LHGJ2021003319）

Application of cisatracurium by different administration methods in renal transplantation

Deng Qun, Jiang Jingjing

Department of Anesthesiology, Zhengzhou Seventh People's Hospital, Zhengzhou 450000, China

Received:2023-01-19 Online:2023-08-15 Published:2023-08-29
Contact: Deng Qun, Email: dengquniu@163.com
Supported by:
Problem-tackling Project of Medical Science and Technology in Henan (LHGJ2021003319)

摘要/Abstract

摘要：

目的　观察在肾移植术的全凭静脉麻醉中通过不同方式给予顺阿曲库铵对麻醉用药量及患者恢复指标的影响。方法　选取郑州市第七人民医院2021年1月至2022年10月于郑州市第七人民医院接受肾移植术治疗的123例患者进行随机对照试验，采用抽签法将其分为A组（62例）和B组（61例）。A组男30例，女32例，年龄（62.58±5.33）岁。B组男31例，女30例，年龄（60.46±5.29）岁。A组靶控输注给药，B组持续输注给药。比较两组麻醉情况、手术情况、术后恢复情况及麻醉安全性。采用t检验和χ²检验。结果　经不同给药方式麻醉后，A组肌松起效时间短于B组，维持时间长于B组（均P<0.05），麻醉维持用药量低于B组［（27.22±5.13）mg比（30.77±5.48）mg；t=3.710，P<0.001］。两组术中出血量及手术时间差异均无统计学意义（均P>0.05）。A组术后睁眼时间、拔管时间均短于B组［（7.45±2.28）min比（8.82±2.36）min、（9.27±2.46）min比（10.49±2.39）min；（t=3.274、2.789，P=0.001、0.006）］。A组肌松恢复程度（TOF）≥25%、≥75%用时均短于B组（均P<0.05）。术后，A组麻醉相关并发症发生率低于B组［4.84%（3/62）比14.75%（9/61）；χ²=5.558，P=0.018］。结论　靶控输注顺阿曲库铵在肾移植术的全凭静脉麻醉中具有较高应用价值，可缩短患者麻醉起效时间，增强肌松效果，对减少麻醉维持用药量、改善肌松恢复情况、降低麻醉相关并发症发生风险均有积极意义。

关键词:

肾移植术, 顺阿曲库铵, 靶控输注, 持续输注

Abstract:

Objective　To observe the effects of total intravenous anesthesia with cisatracurium in different ways for renal transplantation on the anesthetic amount and the patients' recovery indicators. Methods　One hundred and twenty-three patients who took renal transplantation at Zhengzhou Seventh People's Hospital from January 2021 to October 2022 were selected for the randomized controlled trial. They were divided into groups A (62 cases) and B (61 cases) by lottery. There were 30 males and 32 females in group A; they were (62.58±5.33) years old. There were 31 males and 30 females in group B; they were (60.46±5.29) years old. Group A took target-controlled infusion, and group B continuous infusion. The anesthesia, operation, postoperative recovery, and anesthesia safety of the two groups were compared. t and χ² tests were applied. Results　After the anesthesia by different administration methods, the onset time of muscle relaxation in group A was shorter than that in group B, and the maintenance time was longer than that in group B (both P<0.05); the maintenance dose of anesthesia in group A was lower than that in group B [(27.22±5.13) mg vs. (30.77±5.48) mg, t=3.710, P<0.001)]. There were no statistical differences in the intraoperative bleeding volume and operation time between the two groups (both P>0.05). The postoperative eye opening time and extubation time in group A were shorter than those in group B [(7.45±2.28) min vs. (8.82±2.36) min and (9.27±2.46) min vs. (10.49±2.39) min; t=3.274 and 2.789; P=0.001 and 0.006)]. The times for the recovery of muscle relaxation (TOF) ≥ 25% and ≥ 75% in group A were shorter than those in group B (both P<0.05). The incidence of anesthesia related complications in group A was lower than that in group B [4.84% (3/62) vs. 14.75% (9/61); χ²=5.558, P=0.018]. Conclusion　Target controlled infusion of cisatracurium has high application value in total intravenous anesthesia for renal transplantation, can shorten the onset time of anesthesia and enhance the muscle relaxation effect, and has positive significance in reducing the amount of drug in maintaining anesthesia, improving the recovery of muscle relaxation, and reducing the risk of anesthesia related complications.

Key words:

Renal transplantation, Ciatracurium, Target controlled infusion, Continuous infusion

邓群姜晶晶.

顺阿曲库铵不同给药方式在肾移植术中的应用研究 [J]. 国际医药卫生导报, 2023, 29(16): 2277-2280.

Deng Qun, Jiang Jingjing.

Application of cisatracurium by different administration methods in renal transplantation [J]. International Medicine and Health Guidance News, 2023, 29(16): 2277-2280.

参考文献

[1] 中华医学会器官移植学分会. 中国肾移植麻醉技术操作规范(2019版)[J/CD]. 中华移植杂志(电子版),2020,14(1):17-20. DOI:10.3877/cma.j.issn.1674-3903.2020.01.005.
[2] 陈怡静,孙斌,吴钿生,王卓丹,黄焕森.全凭静脉麻醉与静吸复合全麻在胰肾联合移植术的麻醉效果比较[J].广东医学,2019,40(17):2524-2527.
[3] Li X, Zhang B, Xu G, et al. Dosage effect of cisatracurium on intubation and intraoperative neuromonitoring during thyroidectomy: a randomized controlled trial [J]. Gland Surg, 2021, 10(7):2150-2158. DOI: 10.21037/gs-21-109.
[4] 郝建礼,张维清,黄泽清. 不同给药方式的顺式阿曲库铵深肌松应用于老年腹腔镜结直肠癌根治术患者的临床观察[J]. 实用药物与临床,2022,25(3):209-213. DOI:10.14053/j.cnki.ppcr.202203004.
[5] 冯会. 顺式阿曲库铵在不同麻醉中对患者术后苏醒恢复及预后的影响[J/CD]. 中西医结合心血管病电子杂志,2020,8(13):59-60.
[6] Özbudak Ö, Dirol H, Öngüç İ, et al. Is ASA classification useful in risk stratification for EBUS-TBNA? [J]. Turk Thorac J, 2021, 22(5): 364-368. DOI: 10.5152/TurkThoracJ.2021.0120.
[7] 丁修冬,张翼,白光亮,等. 肾移植术前、后的NGAL、补体C1q、sd-LDL、Cys-C等各指标化及其临床意义[J]. 标记免疫分析与临床,2021,28(5):773-778. DOI:10.11748/bjmy.issn.1006-1703.2021.05.012.
[8] 李德媛,张晓峰,吴镜湘,等. 胸科手术中顺阿曲库铵维持深度肌松的静脉输注剂量[J]. 中华麻醉学杂志,2021,41(4):462-465. DOI:10.3760/cma.j.cn131073.20201217.00417.
[9] 贺恺,罗艳,许春梅,等. 顺阿曲库铵不同持续泵注速度对上腹部开腹手术肌肉松弛和肌肉松弛恢复的影响[J]. 上海交通大学学报(医学版),2021,41(8):1125-1128. DOI:10.3969/j.issn.1674-8115.2021.08.022.
[10] Calixto-Flores A, Moreno-Arias JA. Effect of intravenous total anesthesia on hemodynamic changes in renal transplant [J]. Transplant Proc, 2020, 52(4): 1106-1109. DOI: 10.1016/j.transproceed.2020.02.012.
[11] 杨慰.顺式阿曲库铵三种输注方式用于肾移植手术麻醉的效果比较[J].山西卫生健康职业学院学报,2021,31(3):84-86.
[12] 董庆龙,冉建,杨汉宇,等. 罗库溴铵和顺阿曲库铵肌松残余作用发生率分析[J]. 海南医学院学报,2019,25(22):1740-1744,1751. DOI:10.13210/j.cnki.jhmu. 20191030.003.
[13] 韩明杰,张凌宇. 依托咪酯与丙泊酚联合地佐辛用于老年胃镜检查麻醉的临床观察[J]. 国际医药卫生导报,2021,27(13):1980-1984. DOI:10.3760/cma.j.issn.1007-1245. 2021.13.018.
[14] 张燕岭. 靶控输注麻醉对腹腔镜胆囊切除术患者应激反应的影响[J]. 医疗装备,2021,34(6):97-98.
[15] 周桥灵,黄慧慧,刘洪珍,等. 顺式阿曲库铵三种输注方式用于肾移植手术麻醉的效果比较[J]. 实用医药杂志,2017,34(8):684-686,689. DOI:10.14172/j.issn1671-4008. 2017.08.005.
[16] 吴丽莉,季磊,陈素娥. 顺式阿曲库铵闭环靶控输注与持续输注对胆囊切除术病人MAP、HR、SpO2及肌松药物用量的影响[J]. 蚌埠医学院学报,2022,47(9):1233-1236,1240. DOI:10.13898/j.cnki.issn.1000-2200.2022.09.020.
[17] 王颖,张玲,吕宝胜,等. BIS监测下丙泊酚闭环靶控输注麻醉在腹腔镜全子宫切除术中的应用[J]. 中南医学科学杂志,2021,49(6):713-716. DOI:10.15972/j.cnki.43-1509/r.2021.06.024.
[18] 何鑫冉,张建敏,胡璟,等. 闭环靶控输注顺式阿曲库铵在腹腔镜手术患儿中的应用[J]. 临床麻醉学杂志,2021,37(4):364-366. DOI:10.12089/jca.2021.04.007.

顺阿曲库铵不同给药方式在肾移植术中的应用研究

Application of cisatracurium by different administration methods in renal transplantation

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