顺式阿曲库铵和维库溴铵对乳腺癌改良根治术患者麻醉效果及机体应激反应的比较  

Comparison between cisatracurium and vecuronium on anesthesia effects and body stress responses in patients undergoing modified radical mastectomy

作　　者：李杰 代成成 杨洪光[3] 张建中 卜庆丽[3] Li Jie;Dai Chengcheng;Yang Hongguang;Zhang Jianzhong;Bu Qingli(Department of Anesthesiology,Yantai Mountain Hospital,Yantai 264001,China)

机构地区：[1]烟台山医院麻醉科,山东省烟台264001 [2]青岛市中心医院肿瘤科 [3]青岛市市立医院麻醉科

出　　处：《中华航海医学与高气压医学杂志》2021年第4期489-493,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的比较顺式阿曲库铵和维库溴铵对乳腺癌改良根治术中患者的麻醉效果及机体应激反应的影响。方法选取烟台山医院2017年2月至2019年2月接受乳腺癌改良根治术的患者96例为研究对象,采用随机、单盲法将其分为对照组和观察组,每组48例。对照组患者接受顺式阿曲库铵麻醉诱导,观察组患者接受维库溴铵麻醉诱导。对2组患者的麻醉效果和术后不良反应发生率以及麻醉诱导前15 min(T_(0))、麻醉诱导后(T_(1))、气管插管后(T_(2))的血清肾上腺素(E)、去甲肾上腺素(NE)、平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)等指标进行比较。结果观察组患者给药到气管插管时间和气管拔管时间均长于对照组(P<0.01),停用肌松药后自主呼吸恢复时间短于对照组(P<0.01);T_(1)、T_(2)时刻,观察组患者的血清E、NE水平以及MAP和HR均低于对照组(P<0.01),SpO_(2)高于对照组(P<0.01);观察组患者术后不良反应发生率低于对照组(P<0.05)。结论与顺式阿曲库铵相比较,维库溴铵能明显提高乳腺癌改良根治术患者的全麻效果,麻醉起效迅速,麻醉期间血流动力学影响小,且能明显减轻患者的应激反应,安全性较高,值得在临床推广。Objective To compare cisatracurium with vecuronium on their anesthesia effects and body stress response in the patients undergoing modified radical mastectomy.Methods A total of 96 patients received modified radical mastectomy in Yantai Mountain Hospital from February 2017 to February 2019 were divided into control group(n=48)and observation group(n=48)by a random and single-blind method.The patients in the control group were induced by cisatracurium anesthesia,while those in the observation group were induced by vecuronium anesthesia.The anesthetic effect and the incidence of postoperative adverse reactions were compared between the two groups.The epinephrine(E),norepinephrine(NE),mean arterial pressure(MAP),heart rate(HR),oxygen saturation(SaO_(2))at 15 min(T_(0))before anesthesia induction,after anesthesia induction(T_(1)),and at the endotracheal intubation(T_(2))were compared between the two groups.Results The time from administration to intubation,and the time from discontinuing muscle relaxants to extubation in the observation group were significantly longer than those in the control group(P<0.01),and the spontaneous breathing recovery time after discontinuing muscle relaxants in the observation group was significantly shorter than that in the control group(P<0.01).At T_(1),T_(2),the levels of serum E and NE,MAP,and HR in the observation group were significantly lower than those in the control group(P<0.01),but the level of SaO_(2) in the observation group was significantly higher than that in the control group(P<0.01).The incidence of postoperative adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Compared with cisatracurium,vecuronium can significantly improve the anesthesia effect in modified radical mastectomy,with quicker onset effect and less hemodynamic impact during anesthesia.Moreover,vecuronium can obviously reduce the stress response of patients with high safety.Thus it is worth extensive use in clinic.

关 键 词：维库溴铵 顺式阿曲库铵 乳腺癌 改良根治术 麻醉效果 机体应激反应 

分 类 号：R614[医药卫生—麻醉学] R737.9[医药卫生—外科学]