舒更葡糖钠对妇科腹腔镜手术患者术后肌松作用的拮抗效果  

Antagonistic Effects of Sugammadex on Postoperative Neuromuscular Blockade in Patients Accepted Gynecological Laparoscopic Surgery

作　　者：袁峰[1] 董真真[1] 程闪[1] 孙凯[1] 付红光[1] 吴树彪[1] 李姗[1] 张珍珍 YUAN Feng;DONG Zhenzhen;CHENG Shan;SUN Kai;FU Hongguang;WU Shubiao;LI shan;ZHANG Zhenzhen(Department of Anesthesiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院麻醉科,河南郑州450014

出　　处：《河南医学研究》2025年第3期406-410,共5页Henan Medical Research

基　　金：河南省科技发展计划(232102311118)。

摘　　要：目的探讨舒更葡糖钠对妇科腹腔镜手术患者术后肌松作用的拮抗效果。方法选取在郑州大学第二附属医院接受妇科腹腔镜手术的100例患者,随机为两组,每组50例。N+A组:新斯的明+阿托品。S组:舒更葡糖钠。术毕,记录肌松恢复时间和拔管时间;记录肌松拮抗后5 mim(T_(1))、15 min(T_(2))和30 min(T_(3))肌松残余率;记录麻醉前(T_(4))、拔管后5 min(T_(5))和拔管后30 min(T_(6))的动脉血气分析、膈肌移动度(DM)及膈肌厚度比率(DTF);记录术后第1天(T_(7))和第2天(T_(8))的40项恢复质量评分量表(QoR-40)评分、排气时间、排便时间和不良反应的发生率。结果N+A组肌松恢复时间和拔管时间长于S组(P<0.05)。T_(1)和T_(2)时N+A组的肌松残余率高于S组(P<0.05)。T_(5)时刻N+A组的DTF和DM低于S组(P<0.05)。T_(5)和T_(6)时N+A组的动脉血氧分压(PaO_(2))低于S组(P<0.05);T_(5)和T_(6)时N+A组的动脉血二氧化碳分压(PaCO_(2))高于S组(P<0.05);T_(4)时N+A组的脉搏血氧饱和度(SpO_(2))低于S组(P<0.05)。N+A组在T_(7)和T_(8)时的QoR-40评分均低于S组(P<0.05)。N+A组术后的排气时间和排便时间均长于S组(P<0.05)。与N+A组比较,S组患者术后的低氧血症和恶心呕吐的发生率均较低(P<0.05)。结论舒更葡糖钠能够快速有效地逆转妇科腹腔镜手术患者的术后肌松残余,促进患者围手术期自主呼吸尽早恢复,降低患者术后不良事件的发生率,提高患者围手术期的恢复质量,加快患者康复。Objective To investigate antagonistic effects of sugammadex on postoperative neuromuscular blockade in patients accepted gynecological laparoscopic surgery.Methods One hundred patients accepted gynecological laparoscopic surgery were randomly divided into two groups.Each group included 50 patients.Group N+A:neostigrnine combined with atropine.Group S:sugammadex.The times of recovering from neuromuscular block and the extubation were recorded.The occurring rate of residual neuromuscular blockade was recorded after administering the muscle relaxant antagonists at 5 minutes(T_(1)),15 minutes(T_(2))and 30 minutes(T_(3)).The arterial blood gas analysis,the diaphragm motion(DM)and the diaphragm thickening fraction(DTF)were recorded before the anesthetic induction(T_(4)),5 minutes after tracheal extubation(T_(5)),and 30 minutes after tracheal extubation(T_(6)).The 40-item quality of recovery score(QoR-40)of the patients were recorded on the first day(T_(7))and the second day(T_(8))after operation.The times of first flatus and feces were recorded.The incidents of postoperative adverse reactions were recorded.Results The times of recovering from neuromuscular block and the extubation in Group N+A were longer than those in Group S(P<0.05).The occurring rate of residual neuromuscular blockade in Group N+A at T_(1)and T_(2)was higher than that in Group S(P<0.05).The values of the DTF and DM in Group N+A at T_(5)were lower than that in Group S(P<0.05).The values of PaO_(2)in Group N+A at T_(5)and T_(6)were lower than that in Group S(P<0.05).The values of PaCO_(2)in Group N+A at T_(5)and T_(6)were higher than that in Group S(P<0.05).The values of SpO_(2)in Group N+A at T_(4)were lower than that in Group S(P<0.05).The values of QoR-40 in Group N+A at T_(7)and T_(8)were lower than that in Group S(P<0.05).The times of first flatus and feces in Group N+A were longer than those in Group S(P<0.05).Compared with Group N+A,the incidence of postoperative hypoxemia,nausea and vomiting in Group S patients was lower(P<0.05).Conclusion Sug

关 键 词：舒更葡糖钠 妇科腹腔镜手术 罗库溴铵 术后肌松残余 

分 类 号：R614[医药卫生—麻醉学]