老年结直肠癌患者腹腔镜下手术时维库溴铵靶控输注可行浓度的研究  

Research on the Concentration of Vecuronium Bromide Targeted Control Infusion in Laparoscopic Colon / Rectal Cancer Resection of Elderly Patients

作　　者：李学斌[1] 杨毅[1] 苏涛[1] 

机构地区：[1]新疆自治区人民医院,830000

出　　处：《实用癌症杂志》2017年第1期81-83,86,共4页The Practical Journal of Cancer

摘　　要：目的探讨结直肠癌老年患者腹腔镜下行切除术时维库溴铵靶控输注的可行浓度。方法临床纳入72例腹腔镜下行切除术的老年结直肠癌患者72例,根据麻醉维持方法的不同分为静脉组与吸入组。吸入组给予吸入七氟醚辅以瑞芬太尼持续输注,静脉组靶控输注丙泊酚辅以瑞芬太尼静脉持续输注维持麻醉。结果静脉组TOFr恢复到0.7所需时间为(40.48±10.93)min,吸入组为(67.33±17.51)min,差异有显著性(P<0.05);静脉组第1时段、第2时段、第3时段、第4时段、平均效应室浓度分为(0.61±0.04)μg/ml、(0.65±0.01)μg/ml、(0.66±0.03)μg/ml、(0.63±0.03)μg/ml、(0.65±0.02)μg/ml,吸入组分别为(0.46±0.02)μg/ml、(0.42±0.02)μg/ml、(0.40±0.01)μg/ml、(0.32±0.03)μg/ml、(0.38±0.04)μg/ml,差异均有显著性(P<0.05);静脉组停止靶控输注至T1恢复到基础值25%、75%、90%的时间分别为(15.19±3.68)min、(30.93±6.61)min、(32.19±8.78)min,吸入组分别为(23.98±9.78)min、(46.09±9.56)min、(58.14±12.55)min,差异均有显著性(P<0.05)。结论腹腔镜下行切除术的老年结直肠癌患者全身麻醉维持期间,通过靶控输注维库溴铵能够获得较好的肌松效果。吸入全麻时维库溴铵效应室靶浓度比静脉全麻时低,但肌松作用完全恢复时间显著延长。全麻维持期间维库溴铵效应室靶浓度随输注时间延长而逐渐降低。Objective To study the concentration of vecuronium bromide targeted control infusion in laparoscopic colon /rectal cancer resection of elderly patients.Methods 72 cases of elderly patients under laparoscopic colon /rectal cancer resection were selected and divided into vein group and inhalation group based on different method to remain anesthesia.Inhalation group was given inhaled sevoflurane with fentanyl continuous infusion ,while the vein group was given target controlled infusion of propo-fol intravenous group with fentanyl venous continuous infusion to maintain anesthesia.The BIS value was between 40 and 60.When the T1 value of TOF recovered to 5%of the base ,start targeted control vecuronium bromide infusion ,with the original target concentration of.Then adjust the concentration of vecuronium bromide based on T 1 inhibition degree.The T1 value was main-tained between 4%and 6%of the base value.The time from induction to T1 recovery to 5%,TOFr recovery to 0.7,concentration of vecuronium bromide in each stage ,and from stop infusion to T1 recovery to 25%,75%,and 90% of both groups were ob-served.Results The time of TOFr recovery to 0.7 of the vein group was（40.48 ±10.93）min,and（67.33 ±17.51）min for in-halation group,with significant difference （P〈0.05）;The concentration of stage 1,2,3,4,and average of the vein group were （0.61 ±0.04）μg/ml,（0.65 ±0.01）μg/ml,（0.66 ±0.03）μg/ml,（0.63 ±0.03）μg/ml,（0.38-0.04）μg/ml,while （0.46 ± 0.02）μg/ml,（0.42 ±0.02）μg/ml,（0.40 ±0.01）μg/ml,（0.32 ±0.03）μg/ml,（0.65 ±0.02）μg/ml for the inhalation group,with significant difference （ P〈0.05）;The time from stop infusion to T1 recovery to 25%,75%and 90%of the vein group were（15.19 ±3.68）min,（30.93 ±6.61）min and（32.19 ±8.78）min,while（23.98 ±9.78）min,（46.09 ±9.56）min and （58.14 ±12.55）min for the inhalation group,with significant differences （P〈0.05）.Conclusion The effect of vecuronium bromide targeted control infusion to re

关 键 词：腹腔镜结/直肠癌切除术 维库溴铵 靶控输注 浓度 

分 类 号：R735.37[医药卫生—肿瘤]