顺式阿曲库铵在肾功损害患者手术中肌松效应的观察  

The intraoperative muscle-relaxant effect of cis-atracurium on the patients with impaired renal function

作　　者：王静[1] 丁冠男[2] 

机构地区：[1]枣庄市立医院麻醉科,277100 [2]首都医科大学附属北京友谊医院麻醉科

出　　处：《国际麻醉学与复苏杂志》2012年第6期384-385,391,共3页International Journal of Anesthesiology and Resuscitation

摘　　要：目的探讨顺式阿曲库铵在肾功损害患者手术时应用的肌松效果及安全性。方法选择20例肾功损害患者行急诊剖腹探查手术为观察组，20例肾功正常患者行急诊剖腹探查手术为对照组。两组均采用相同方法麻醉及维持，用Organon加速度仪进行肌松监测，分别记录起效时间（T。达最大阻滞时间），无反应期（T1达最大阻滞至T1开始恢复的时间），T1恢复到25％、75％的时间及恢复指数（T1从25％恢复至75％的时间）。结果两组患者的性别、身高、体重、手术时间差异均无统计学意义，观察组术前肾功能各项指标[血尿素氮（15．4±5．6）mmol／L，血肌酐（320±45）μmol／L]均显著高于对照组[血尿素氮（4．4±2．6）mmol／L，血肌酐（132±25）μmol／L]（P〈0．05）。顺式阿曲库铵在观察组患者的起效时间较对照组稍延长，但差异没有统计学意义（P〉0．05），两组患者无反应期和T1恢复到25％、75％的时间及恢复指数差异均无统计学意义（P〉0．05）。结论顺式阿曲库铵可以安全用于肾功损害患者麻醉。Objective To investigate the intraoperative muscle-relaxant effect and safety of Cis-atracurium on the patients with impaired renal function. Methods 20 patients with impaired renal function undergoing emergency laparotomy were the observation group, 20 patients with normal renal function undergoing emergency laparotomy were the control group. All patients were anesthetized and maintained in the same method. Neuromuscular blocking effects were monitored using the Organon accelograph. The onset time （T1 up to a maximum block time）, no reaction time （Tl of the greatest block to T1 recovery）, TI 25% recovery time, T1 75% recovery time and recovery index （T1 recovery from 25% to 75% of the time） were recorded. Results There were not significant differences in sex, height, weight and operative time between two groups （P〉0.05）. The renal function indicators[blood urea nitrogen （15.4±5.6） mmol/L, serum creatinine （320±45） μmol/L] in the observation group were higher than those[blood urea nitrogen （4.4±2.6） mmol/L, serum creatinine （132±25） μmol/L] in the control group （P〈0.05）. The onset time in the observation group is slightly longer than that in the control group, but the difference was not significant （P〉0.05）. There were no significant difference in no reaction time, Tl 25% recovery time, T1 75% recovery time and recovery index between two groups （P〉0.05）. Conclusions Cis-atracurium could be safely used in patients with impared renal function.

关 键 词：顺式阿曲库铵 神经肌肉阻滞 肾功损害 

分 类 号：R614[医药卫生—麻醉学]