不同剂量琥珀胆碱在精神分裂症改良电休克治疗全麻诱导中的应用效果比较  

Comparison of Application Effects of Different Doses of Succinylcholine in the Induction of General Anesthesia in Modified Electroconvulsive Therapy for Schizophrenia

作　　者：吴国彬 李印玉 李俊领 王中玉[3] WU Guobin;LI Yinyu;LI Junling;WANG Zhongyu(Department of Anesthesiology,Dancheng County Central Hospital,Zhoukou 477150,China;Department of Anesthesiology,Zhoukou Central Hospital,Zhoukou 466000,China;Department of Anesthesiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郸城县中心医院麻醉科,河南周口477150 [2]周口市中心医院麻醉科,河南周口466000 [3]郑州大学第一附属医院麻醉科,河南郑州450000

出　　处：《河南医学研究》2022年第13期2390-2393,共4页Henan Medical Research

摘　　要：目的比较不同剂量琥珀胆碱在精神分裂症改良电休克治疗(MECT)全麻诱导中的应用效果。方法选择2019年12月至2020年12月于郸城县中心医院进行MECT治疗的106例精神分裂症患者,按随机数字表法分为对照组(丙泊酚+1.0 mg·kg^(-1)琥珀胆碱)、研究组(丙泊酚+1.4 mg·kg^(-1)琥珀胆碱),各53例。比较两组不同时刻[麻醉前即刻(T_(1))、电击后即刻(T_(2))、电击后3 min(T_(3))、电击后5 min(T_(4))]心率(HR)、平均脉动压(MAP)的变化,比较两组麻醉前、电击结束后应激反应[去甲肾上腺素(NE)、皮质醇(Cor)、5-羟色胺(5-HT)、多巴胺(DA)]表达水平及电休克相关指标、简易精神状态检查(MMSE)量表评分、不良反应发生率。结果两组HR、MAP比较,T_(1)时研究组与对照组差异无统计学意义(P>0.05);T_(2)、T_(3)、T_(4)时研究组HR、MAP均低于对照组(P<0.05);两组能量抑制指数差异无统计学意义(P>0.05),研究组自主呼吸恢复时间短于对照组,苏醒时间、癫痫发作时间长于对照组(P<0.05);电击结束后研究组MMSE评分高于对照组(P<0.05);电击结束后研究组NE、Cor表达水平均低于对照组,5-HT、DA表达水平均高于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论丙泊酚复合1.4 mg·kg^(-1)琥珀胆碱可明显改善精神分裂症患者MECT治疗后血流动力学指标、认知功能,并减轻应激水平。Objective To compare the application effect of different doses of succinylcholine in the induction of general anesthesia in modified electroconvulsive therapy(MECT)for schizophrenia.Methods A total of 106 patients with schizophrenia who received MECT treatment in Dancheng County Central Hospital from December 2019 to December 2020 were selected and divided into control group(propofol+1.0 mg·kg^(-1) succinylcholine)and research group(propofol+1.4 mg·kg^(-1) succinylcholine)according to the random number table method,53 cases in each.The changes of heart rate(HR)and mean pulsatile pressure(MAP)were compared between the two groups at different times[immediately before anesthesia(T_(1)),immediately after electric shock(T_(2)),3 minutes after electric shock(T_(3)),and 5 minutes after electric shock(T_(4))].The expression levels of stress response[norepinephrine(NE),cortisol(Cor),5-hydroxytryptamine(5-HT),dopamine(DA)],electroshock-related indexes,mini-mental state examination(MMSE)scale scale,and incidence of adverse reactions were compared between the two groups before anesthesia and after electric shock.Results Compared with the HR and MAP of the two groups,there was no significant difference between the study group and the control group at T_(1)(P>0.05).HR and MAP of the study group were lower than those of the control group at T_(2),T_(3) and T_(4)(P<0.05).There was no significant difference in index(P>0.05),the recovery time of spontaneous breathing in the study group was shorter than that in the control group,and the recovery time and seizure time were longer than those in the control group(P<0.05).After the electric shock,the expression levels of NE and Cor in the study group were lower than those in the control group,and the expression levels of 5-HT and DA were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P<0.05).Conclusion Propofol combined with 1.4 mg·kg^(-1) succinylcholine can significantly improve hemody

关 键 词：全麻 琥珀胆碱 精神分裂症 改良电休克治疗 简易精神状态检查量表 

分 类 号：R614.2[医药卫生—麻醉学]