肌松监测在肥胖症患者腹腔镜下袖状胃切除术中的应用  

The Use of Muscle Relaxation Monitoring during Laparoscopic Sleeve Gastrectomy in Obese Patients

作　　者：王浩 龙云 Wang hao;Long yun(The Affiliated Jiangning Hospital to Nanjing Medical University,Nanjing 211100,China)

机构地区：[1]南京医科大学附属江宁医院麻醉科,江苏南京211101

出　　处：《哈尔滨医药》2024年第1期45-47,共3页Harbin Medical Journal

基　　金：南京市卫生科技发展专项基金项目(YKK23221)。

摘　　要：目的分析肌松监测在肥胖症患者腹腔镜下袖状胃切除术指导术中深度肌松以及术后拔管的应用效果。方法选取80例肥胖症患者,均拟实施腹腔镜下袖状胃切除术。采取随机数字表分组原则将其分为对照组(常规监测方式)、观察组(肌松监测),各40例,对照分析不同监测方式的应用效果。结果观察组肌松药物使用总量、术后苏醒时间、术后拔管时间、手术结束后(T2)乳酸、离开麻醉恢复室(T3)乳酸、手术60min(T1)血糖、手术结束后(T2)血糖、离开麻醉恢复室(T3)血糖、低氧血症总发生率均低于对照组(P<0.05)。结论在肥胖症患者腹腔镜下袖状胃切除术治疗中采取肌松监测方式,能对术中深度肌松起到指导作用,减少术中肌松药物使用剂量,保障围术期血糖、乳酸的平稳性,可缩短患者术后苏醒时间、拔管时间,降低术后低氧血症发生风险,值得推荐。Objective to explore and analyse the application effect of muscle relaxation monitoring in guiding intraoperative deep muscle relaxation during laparoscopic sleeve gastrectomy and postoperative extubation in obese patients.Methods 80 obese patients treated in our hospital from January 2022 to November 2023 were selected,all of whom were proposed to undergo laparoscopic sleeve gastrectomy.The patients were divided into the control group(conventional monitoring mode)and the observation group(muscle relaxation monitoring),with 40 cases,and the application effects of different monitoring modes were analyzed.Results The total amount of muscarinic drugs used,postoperative awakening time,postoperative extubation time,end surgery(T2)lactate,leaving the anaesthesia recovery room(T3)lactate,blood glucose at 60min of surgery(T1),end surgery(T2)blood glucose,leaving the anaesthesia recovery room(T3)blood glucose,and the total incidence of hypoxemia in the observation group were lower than those in the control group(P<0.05).Conclusion It is worth recommending that obese patients undergoing laparoscopic sleeve gastrectomy be treated with muscle relaxation monitoring to ensure smooth perioperative blood glucose and lactic acid management,guide intraoperative deep myosin,minimize intraoperative myosin drug dosage,shorten postoperative awakening and extubation times,and lower the risk of postoperative hypoxemia.

关 键 词：肌松监测 肥胖症 腹腔镜 袖状胃切除术 术中深度肌松 术后拔管 

分 类 号：R734.2[医药卫生—肿瘤]