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tang niao bing bing ren ying yong a qu ku zuo yu wei ku zuo zuo hou can yu ji song zuo yong de bi jiao
Author(s): 
Pages: 2367-2368
Year: Issue:  20
Journal: THE JOURNAL OF PRACTICAL MEDICINE

Keyword:  糖尿病2型阿曲库铵维库溴铵残余肌松;
Abstract: 目的:比较糖尿病病人应用阿曲库铵和维库溴铵术后残余肌松作用的差异.方法:32例ASAⅡ级成年腹部手术合并2型糖尿病病人,分为阿曲库铵组和维库溴铵组,麻醉诱导为静注异丙酚1.5~2 mg/kg,芬太尼4μg/kg,阿曲库铵0.75 mg/kg或维库溴铵0.15 mg/kg,气管插管后行机械控制呼吸,麻醉维持为持续泵注异丙酚.间断给予芬太尼.用Datex-Engstrom多功能监护仪M-NMT模块监测肌松,在4个成串刺激(TOF)出现1个颤搐反应时静注新斯的明0.04mg/kg和阿托品0.02 mg/kg拮抗,分别观察两组病人拮抗后15 min和30 min时残余肌松(TOFR<0.7和<0.9)的发生率.结果:拮抗后15 min阿曲库铵组TOFR<0.7的病例数比维库溴铵组少,但无明显差异(4:7,P>0.05),而拮抗后30 min阿曲库铵组TOFR<0.9的病例数明显低于维库溴铵组(6:12,P<0.05).结论:(1)糖尿病病人应用阿曲库铵后残余肌松发生率比维库溴铵低.(2)糖尿病病人术后残余肌松发生率比非糖尿病人高,应用非去极化肌松药后应常规给予拮抗,以TOFR≥0.9作为神经肌肉恢复标准为好.
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