罗库溴铵与苯磺顺阿曲库铵麻醉对腹部手术血流动力学与感染的对比研究

Clinical comparative study on hemodynamics of rocuronium and cisatracurium besylate and infections in anesthesia for abdominal surgery

目的探讨罗库溴铵与苯磺顺阿曲库铵麻醉条件下对腹部手术肌松效果、血流动力学与感染的对比。方法选取2010年1月-2014年12月100例行腹腔镜胆囊切除术患者进行研究,随机将其分为对照组和观察组,每组各50例,观察组给予罗库溴铵肌松药物,对照组给予苯磺顺阿曲库铵肌松药物,比较两组患者感染率及气管插管总有效率,诱导前和诱导后的平均动脉压和心律,肌松的起效时间、持续时间、恢复指数,数据采用SPSS19.0软件进行统计分析。结果观察组患者呼吸道感染率24.00%,显著低于对照组患者的36.00%,差异有统计学意义(P<0.05);观察组气管插管总有效率为96.00%、肌松起效时间(2.57±0.61)min,显著高于对照组的86.00%、(1.49±0.38)min,差异有统计学意义(P<0.05);观察组肌松持续时间和恢复指数显著低于对照组,差异有统计学意义(P<0.05);两组患者诱导前后的平均动脉压和心律比较,差异无统计学意义。结论罗库溴铵用于腹部手术全麻气管插管术的持续时间短,恢复迅速,发生呼吸道感染率低,不良反应少,是较理想的肌肉松弛药。

OBJECTIVE To explore the effect of rocuronium and cisatracurium besylate on muscle relaxation,hemodynamics and infections in anesthesia for abdominal surgery.METHODS The 100 patients who underwent laparoscopic cholecystectomy from Jan.2010 to Dec.2014 were selected and randomly divided into the control group and the observation group,50 patients in each group.The observation group was given rocuronium for muscle relaxation,while the control group received cisatracurium besylate.The infection rates,the total effective rates of endotracheal intubation and the changes of MAP and HR before and after operation were compared between the two groups.Besides,the onset time and the effective time of muscle relaxation and the recovery indexes were also recorded.Data were statistically analyzed by software SPSS 19.0.RESULTS The incidence of respiratory infections was 24.00%in the observation group,significantly lower than 36.00%in the control group（P〈0.05）.The total effective rate of endotracheal intubation and the onset time of muscle relaxation were 96.00% and（2.57±0.61）min in the observation group,significantly higher than 86.00% and（1.49±0.38）min in the control group（P〈0.05）.The effective time and the recovery index were significantly lower in the observation group than those in the control group（P〈0.05）.MAP and HR after operation in the two groups had no obvious difference compared with before operation.CONCLUSION Rocuronium for endotracheal intubation under anesthesia in abdominal surgery has advantages such as short duration can rapid recovery with low incidence of respiratory infection and fewer adverse reactions,which is an ideal muscle relaxant.