七氟烷对Ⅱ型糖尿病患者罗库溴铵残余肌松效应的影响  

The effect of sevoflurane on residual neuromuscular blockade induced by rocuronium in patients with type Ⅱ diabetes mellitus

作　　者：武云飞[1] 杨文慧 

机构地区：[1]包头市中心医院麻醉科,内蒙古包头014040 [2]包头中心医院妇产科

出　　处：《包头医学院学报》2015年第9期14-15,共2页Journal of Baotou Medical College

摘　　要：目的:探讨糖尿病患者七氟烷全身麻醉下对罗库溴铵肌松时效影响。方法:七氟烷全身麻醉下行择期手术的患者60例,其中观察组30例,为糖尿病患者。对照组30例,为非糖尿病患者,两组患者全麻诱导时快速静注罗库溴铵(0.6 mg/kg)。记录两组患者静注罗库嗅铵后出现4个成串刺激(train of four stimulation,TOF)出现的时间,分别为T1、T2、T3、T4,从肌松药注射完毕至TOF比值恢复至70%、90%的时间,从T2出现至TOF恢复至90%的时间及术前电解质数值。结果:糖尿病组患者静注罗库溴铵后T1、T2、T3、T4出现的时间比非糖尿病患者延长,从肌松药注射完毕至TOF比值恢复至70%、90%的时间以及从T2出现至TOF比值恢复至90%的时间比非糖尿病患者延长,差异有统计学意义(P<0.05)。结论:七氟烷全身麻醉下糖尿病患者静注罗库溴铵发生残余肌松的可能性高于非糖尿病患者。Objective： To investigate the effect of general anesthesia of sevoflurane on the neuromuscular response to rocuronium in patients with typeⅡdiabetes mellitus（ T2DM）. Methods： Sixty patients receiving elective surgery under general anesthesia of sevoflurane were divided into two groups. 30 patients with T2 DM were in observation group and 30 non- diabetes patients were as the controls. The patients in the two groups were given rocuronium（ 0. 6mg / kg） in vein swiftly when induced by general anesthesia,after which the time of the train- of- four stimulation in the two groups was recorded. The time was as follows： from rocuronium injection to TOF ratio of 0. 7（ T1） and 0. 9（ T2）,from the occurrence of T2 to the recovery of TOF ratio of 0. 9（ T3） and preoperative electrolyte values（ T4）. Results： A significant prolongation of occurrence of T1,T2,T3,T4 appeared in the T2 DM group compared with the control group after intravenous injection of rocuronium. The time from rocuronium injection to TOF ratio of 0. 7（ T1） and 0. 9（ T2）,and from the occurrence of T2 to the recovery of TOF ratio of 0. 9（ T3） was prolonged than that in non- diabetes patients,with difference significant（ P 〈0. 05）. Conclusion： Patients with T2 DM under general anesthesia of sevoflurane have an increased risk of residual neuromuscular blockage after rocuronium administration compared with non- diabetes ones.

关 键 词：糖尿病 全身麻醉 七氟烷 罗库溴铵 

分 类 号：R614[医药卫生—麻醉学]