罗库溴铵用于肝癌手术全麻诱导气管插管的血流动力学及感染发生的观察  

Observation of hemodynamics and infection of application of rocuronium in liver cancer patients with general anesthesia induction tracheal intubation

作　　者：朱韵甜[1] 张润泽[1] 解康杰[1] 连燕虹[1] 方军[1] 

机构地区：[1]浙江省肿瘤医院麻醉科,浙江杭州310022

出　　处：《中华医院感染学杂志》2017年第11期2532-2535,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2017175116)

摘　　要：目的了解罗库溴铵和苯磺顺阿曲库铵用于肝癌手术全麻诱导气管插管的血流动力学及感染发生情况,为肝癌手术全麻快诱导插管选择安全有效的肌松药提供参考。方法 2014年1月-2015年12月收治的148例肝癌手术患者被随机分为观察组76例和对照组72例,两组均行全麻气管插管术,观察组所用肌松药为罗库溴铵,对照组使用苯磺顺阿曲库铵,参照Cooper评分法评价两组的气管插入条件;评价肌肉松弛效果;在给药前及给药后1、3、5min时检查两组的心率、平均动脉压;观察住院期间出现的医院感染发生率。结果观察组Cooper评分明显优于对照组,差异有统计学意义(P<0.05);观察组起效时间明显低于对照组,差异有统计学意义(P<0.05);两组之间的临床作用时间、恢复指数差异均无统计学意义;给药后1、3、5min,观察组心率、平均动脉压与给药前的差异均无统计学意义;对照组心率高于给药前,平均动脉压低于给药前(P均<0.05);给药后观察组心率低于对照组,平均动脉压高于对照组(P均<0.05);观察组医院感染率13.16%(10/76);对照组25.00%(18/72);差异无统计学意义;在28例呼吸道感染患者的痰培养标本中检出33株病原菌,其中以革兰阴性菌为主占63.64%,未检出真菌,主要病原菌是肺炎克雷伯菌、金黄色葡萄球菌等。结论罗库溴铵用于肝癌手术全麻诱导气管插管的肌松起效时间较短,对血流动力学指标的影响较小,患者呼吸道感染率较低,具有较高的临床应用价值。OBJECTIVE To investigate hemodynamics and infection of application of rocuronium and cisatracurium besilate in liver cancer patients with general anesthesia induction tracheal intubation,so as to provide references for selecting safe and effective neuromuscular blocking agents for tracheal intubation under general anesthesia.METHODS A total of 148 cases of hospitalized liver cancer patients from Jan.2014 to Dec.2015 were randomly divided into 76 cases of observation group and 72 cases of control group.Two groups were performed tracheal intubation anesthesia,rocuronium was used for observation group,and cisatracurium besilate was used for control group.The tracheal insertion conditions of two groups were evaluated according to Cooper score method,the effects of muscle relaxation were evaluated,,the heart rate and mean arterial pressure of the two groups before and at 1,3,5 min after administration were tested,and the incidences of nosocomial infection during hospitalization were observed.RESULTS Cooper score of observation group was significantly better than that of control group （P〈0.05）.The onset time of observation group was significantly lower than that of control group （P〈0.05）.There was no significant difference between the two groups in the clinical duration and recovery index.After 1,3 and 5 min of administration,heart rate and mean arterial pressure of observation group and those before the treatment were not significant.The heart rate of control group was higher than that before administration,and the mean arterial pressure was lower than that before injection （P〈0.05）.The heart rate of observation group after administration was lower than control group,and the mean arterial pressure was higher than that of control group （P〈0.05）.The nosocomial infection rate was 13.16% in observation group （10/76）,and 25.00% （18/72） in control group,and there was no significant difference.In the sputum samples of 28 cases of respiratory tract infection,33 strains of pathogenic bacteria we

关 键 词：罗库溴铵 肝癌手术 全麻诱导气管插管 血流动力学指标 医院感染 

分 类 号：R614.2[医药卫生—麻醉学]