术前新辅助化疗对乳腺癌根治术患者顺式阿曲库铵肌松效应的影响  

Effect of Preoperative Neoadjuvant Chemotherapy on Muscle Relaxation Effectiveness Induced by Cis-atracurium in Patients with Radical Mastectomy for Breast Cancer

作　　者：赵婷[1] 肖春龙[1] ZHAO Ting;XIAO Chun-long(Department of Anesthesia Surgery,Baoji Hospital of Traditional Chinese Medicine,Baoji,Shaanxi 721001,China)

机构地区：[1]宝鸡市中医医院麻醉手术科,陕西宝鸡721001

出　　处：《解放军医药杂志》2018年第3期44-47,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：陕西省卫生厅科研基金项目(2014JK40398)

摘　　要：目的术前新辅助化疗对乳腺癌根治术患者顺式阿曲库铵肌松效应的影响。方法选取2014年1月—2017年1月行乳腺癌根治术治疗的72例乳腺癌患者作为研究对象,采用回顾性分析法分析所有患者的临床资料,根据患者是否在术前采用新辅助化疗将其分为对照组(术前未行新辅助化疗)38例和观察组(术前行新辅助化疗)34例,所有患者在手术过程中均采用顺式阿曲库铵进行麻醉诱导。比较两组的肌松起效时间(t_1)、第一个肌颤搐振幅(T_1)持续为0的时间(t_2)、T_1恢复至10%所需时间(t_3)、T_1恢复至25%所需时间(t_4)、T_1恢复至90%所需时间(t_5)、恢复指数(RI)以及4个成串刺激(TOF)比值恢复至90%的时间(t_6)。并观察两组手术过程中顺式阿曲库铵的使用量、平均输注速率以及不良反应情况。结果观察组t_1、t_4、t_5、RI和t_6时间均较对照组延长,而t_2和t_3时间均较对照组缩短(P<0.01)。观察组手术过程中不同时间段的顺式阿曲库铵使用量较对照组多,且平均输注速率较对照组快(P<0.01)。两组不良反应发生率比较差异无统计学意义(χ~2=1.560,P=0.211)。结论术前进行新辅助化疗可减弱乳腺癌根治术患者手术过程中顺式阿曲库铵的肌松作用。Objective To investigate effect of preoperative neoadjuvant chemotherapy on muscle relaxation effectiveness induced by Cis-atracurium in patients with radical mastectomy for breast cancer.Methods A total of 72 patients with radical mastectomy for breast cancer during January 2014 and January 2017 were selected as research subjects,and retrospective analysis was used to analyze clinical data of all patients,and then the patients were divided into control group(n=38,non-preoperative neoadjuvant chemotherapy)and observation group(n=34,preoperative neoadjuvant chemotherapy)according to whether or not having preoperative neoadjuvant chemotherapy,and all patients had anesthesia induction of Cis-atracurium during the operation.In two groups,onset time of muscle relaxation(t 1),the first muscle twitch amplitude(T 1),continued for 0(t 2),required time of returning to 10%T 1(t 3),required time of returning to 25%T 1(t 4),required time of returning to 90%T 1(t 5),recovery index(RI)and required time of returning to 90%train-of-four(TOF)stimulations ratio(t 6)were compared;Cis-atracurium doses,the average infusion rate and incidence rate of adverse reactions during the operation were observed.Results In observation group,times of t 1,t 4,t 5,RI and t 6 were significantly longer,while t 2 and t 3 times were significantly shorter than those in control group(P<0.01);Cis-atracurium doses in different operation times were more,and the average infusion rate was faster than those in control group(P<0.01).The difference in incidence rate of adverse reactions was not statistically significant in two groups(χ2=1.560,P=0.211).Conclusion Preoperative neoadjuvant chemotherapy may weaken muscle relaxation effectiveness induced by Cis-atracurium during the radical mastectomy for patients with breast cancer.

关 键 词：新辅助化疗 乳腺肿瘤 顺式阿曲库铵 肌松弛 

分 类 号：R737.9[医药卫生—肿瘤] R614[医药卫生—临床医学]