老年全麻患者肌松闭环监测的应用观察及术后肺部感染的预防

Application of muscle relaxation closed loop monitoring system in general anesthesia for elderly patients and prevention of postoperative pulmonary infections

目的观察闭环肌松注射系统在老年全麻患者的临床效果及安全性,以预防老年患者术后肺部感染。方法随机选取2010年2月-2012年2月进行上腹部手术的老年全麻手术(ASAⅠ-Ⅱ级)患者100例为研究对象,将其分为A、B两组,每组50例,A组为AEP闭环肌松注射系统组,B组为传统经验对照组,观察两组患者平均动脉压、心率、呼吸频率等数值,记录肌松药总量、诱导苏醒时间及术后不良反应与肺部感染情况。结果 A组在Copper评级、麻醉医师、手术医师满意率均高于B组,差异有统计学意义(P<0.05);A组术后发生肺部感染8例,感染率16.0%;B组术后发生肺部感染11例,感染率22.0%。结论闭环肌松注射系统在老年全身麻醉中可有效指导麻醉期间肌松药的合理应用,并减少术后残余肌松的发生率及术后感染率,从而提高老年患者全麻安全性。

OBJECTIVE To observe the clinical effect and safety of the closed-loop muscle relaxation injection system used by the elderly patients during general anesthesia so as to prevent the postoperative pulmonary infections.METHODS A total of 100 elderly patients（with the general anesthesia of ASⅠ-Ⅱ class） who underwent upper abdominal surgery from Feb 2010 to Feb 2012 were randomly selected as the study subjects and were divided into the group A（the AEP closed-loop muscle relaxant injection system group） and the group B（traditional experience control group）,with 50 cases in each.The mean arterial pressure,heart rate,and respiratory rate of the two groups were observed,and the total muscle relaxants,induced total recovery time and postoperative adverse reactions,and pulmonary infections were recorded.RESULTS The copper rating,anaesthetists satisfaction rate,and the operation physician satisfaction rate of the group A were all higher than the group B,the difference was statistically significant（P0.05）.There were 8 cases with pulmonary infections in the group A with the infection rate of 16.0%,and there were 11 cases with the postoperative pulmonary infections in the group B with the infection rate of 22.0%.CONCLUSION The closed-loop muscle relaxant injection system used by the elderly patients with general anesthesia can effectively guide the reasonable use of muscle relaxants during anesthesia and reduce the incidence of residual paralysis,thereby improving the safety of elderly patients with general anesthesia.