顺式阿曲库铵在大容量全肺灌洗术中的应用体会  

Application experience of cisatracurium in large capacity whole lung lavage

作　　者：张洪文[1] 陈刚[1] 马国宣[1] 段建勇[1] 

机构地区：[1]中国煤矿工人北戴河疗养院尘肺科,066104

出　　处：《中国疗养医学》2013年第3期202-203,共2页Chinese Journal of Convalescent Medicine

摘　　要：目的探讨顺式阿曲库铵在大容量全肺灌洗术中的应用。方法随机选取30例尘肺患者为研究对象,采用顺式阿曲库铵作为肌肉松弛剂(治疗组),另选取年龄、尘肺期别与之相近的30例患者,采用维库溴铵作为肌肉松弛剂(对照组),选取30例肝功能异常的尘肺患者为另一对照组,采用顺式阿曲库铵作为肌肉松弛剂,手术结束三组均给予标准剂量抗胆碱药拮抗肌松。比较三组药物作用时间、自主呼吸恢复时间、拔管时间及肺灌洗术中的心血管反应、皮肤颜色改变。结果术中维持时间、苏醒时间、拔管时间顺式阿曲库铵组分别为(22.4±2.2)min、(25.1±5.9)min、(5.6±3.2)min,维库溴铵组分别为(25.2±2.9)min、(35.4±6.3)min、(10.1±4.5)min,两组比较差异有高度统计学意义(P<0.01);肝功能异常组分别为(22.8±3.1)min、(25.6±5.5)min、(5.5±3.4)min,与顺式阿曲库铵组比较,差异无统计学意义;三组术中均能维持稳定的心率、血压,无心血管反应,无组铵释放作用。结论顺式阿曲库铵具有起效快、作用强、自主呼吸恢复快、拔管快的特点,且不经过肝肾代谢,为大容量全肺灌洗提供较好的麻醉效果,特别适于肝功能异常者的肺灌洗治疗。Objective To probe into the application of cisatracurium in large capacity whole lung lavage. Methods 30 sufferers with pneumoconiosis were randomly selected to be the subjects given cisatracurium as muscle relaxant （the treatment group）, while another 30 sufferers with pneumoconiosis of similar age and stage given vecuronium bromide as muscle relaxant（the control group）.30 sufferers with pneumoconiosis and abnormal liver function were in another control group given cisatracurium as muscle relaxant.After operation, the three groups were given standard dose of anticholinergic agent antagonistic muscle relaxants.Comparison was made among the three groups in terms of drug action time, autonomous respiration recovery time, extubation time, cardiovascular response and skin color change in the lung lavage.Results The hold time during operation, recovery time, and extubation time were respectively（22.4±2.2）min, （25.1 ± 5.9）min, （5.6± 3.2）min in the cisatracurium group, （25.2± 2.9）min, （35.4± 6.3）min, （10.1 ± 4.5）min in the vecuronium bromide group, and the differences between the two groups were of high statistical significance （P〈 0.01 ）.They were （22.8 ± 3.1 ）min, （25.6± 5.5）min ,（5.5± 3.4）min in the abnormal liver function group and the differences between the two groups were not of statistical significance.After operation, the three groups all can maintain stable heart rate, blood pressure without cardiovascular response or effect of histamine release.Conclusion Cisatracurium has the characteristics of rapid action, strong effect, quick autonomous respiration recovery, fast extubation, without liver and kidney metabolization so as to provide good anesthetic effect for large capacity whole lung lavage, which is especially suitable for lung lavage for sufferers with abnormal liver function.

关 键 词：顺式阿曲库铵 大容量全肺灌洗 麻醉 

分 类 号：R614[医药卫生—麻醉学]