舒更葡糖钠与新斯的明拮抗胰肾联合移植术后残余肌松效果的比较  

Sugammadex versus neostigmine for reversal of residual neuromuscular blockade in patients undergoing simultaneous pancreas-kidney transplantation

作　　者：周洪彬[1] 黄焕森[1] 许阳英[1] 刘浩[1] 吴钿生[1] ZHOU Hongbin;HUANG Huansen;XU Yangying;LIU Hao;WU Diansheng(Department of Anesthesiology,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院麻醉科,广州510260

出　　处：《实用医学杂志》2022年第3期366-369,共4页The Journal of Practical Medicine

基　　金：广东省自然科学基金资助项目(编号:2021A1515010255)。

摘　　要：目的比较舒更葡糖钠与新斯的明拮抗胰肾联合移植术后残余肌松的效果。方法收集2017年1月至2021年5月我院胰肾联合移植术患者152例,根据肌松拮抗剂使用情况分为:舒更葡糖钠组(S组)82例和新斯的明组(N组)70例。比较两组患者肌松拮抗剂效能、术前及术后1、3、7、14 d的血清肌酐清除率、血淀粉酶值及空腹血糖值、两组术后并发症情况,组间比较计量资料采用两样本t检验或非参数检验,计数资料采用χ^(2)检验。结果与N组比较,S组肌松拮抗剂起效[3(2,7)min vs.15(10,32)min]、自主呼吸恢复[4(3,7)min vs.25(13,45)min]、气管拔管[17(10,25)min vs.47(30,86)min]和PACU停留时间[30(15,46)min vs.61(21,95)min]明显缩短(P<0.05),术后低氧血症[2(2.4%)vs.9(12.9%)]及肺部感染发生率[4(4.9%)vs.12(17.1%)]明显降低(P<0.05);两组各时点肌酐清除率、血淀粉酶、空腹血糖比较差异无统计学意义(P>0.05);两组其余并发症发生率比较差异无统计学意义(P>0.05)。结论与新斯的明相比,舒更葡糖钠有利于加快胰肾联合移植患者术后肌松恢复,降低术后早期肺部并发症发生率。Objective To compare the efficacy and safety of sugammadex versus neostigmine for reversal of residual neuromuscular blockade in patients undergoing simultaneous pancreas-kidney transplantation.Methods The patients undergoing simultaneous pancreas-kidney transplantation from January 2017 to May 2021 were included and divided into 2 groups:sugammadex group(group S)and neostigmine group(group N).Demographic characteristics,effective time,spontaneous breathing recovery time,extubation time,post-anesthesia care unit(PACU)stay and hospital stay were recorded.The two groups were compared in terms of postoperative complications,creatinine clearance rate,serum amylase and fasting blood glucose before surgery and on the 1st,3rd,7th,14th day postoperatively.Results A total of 152 patients were enrolled:82 in group S and 70 in group N.Compared with group N,the effective time,spontaneous breathing recovery,extubation time and PACU stay in group S were much shorter.The incidences of postoperative hypoxemia and pulmonary infection of group S were much lower than group N(P<0.05).There were no statistically significant differences in the creatinine clearance rate and the levels of serum amylase and fasting blood glucose as well as in the incidences of other postoperative complications between the two groups.Conclusions Sugammadex is better than neostigmine at promoting the reversal of residual neuromuscular blockade and lowering postoperative pulmonary complications.

关 键 词：舒更葡糖钠 新斯的明 胰肾联合移植 呼吸功能恢复 肺部并发症 

分 类 号：R614[医药卫生—麻醉学]