肌松监测下老年患者术后拔管安全性和有效性观察

The Safety and Efficiency of Post-operative Extubation under Muscle Relaxation Monitoring in Senile Patients

目的观察老年全麻手术患者在肌松监测仪监测下行术后拔管的安全性及有效性。方法选择全麻下行腹腔镜胆囊切除术老年患者(年龄60~85岁)80例,随机分为两组:S组(术后肌松监测下拔管)和D组(临床经验评估下拔管)。对照观察两组患者术前(T_0)、拔管时(T_1)、拔管后15 min(T_2)及30 min(T_3)四个时间点的MAP,HR,SPO_2,于T_0、T_1、T_2及T_3时点测动脉血气,记录其乳酸Lac,(blood lactic acid)及SO_2值,对其进行pearson相关性分析。结果在T_2和T_3时点,S组与D组患者比较SPO_2,差异有统计学意义(P<0.05);动脉Lac及SO_2值在T_1时点pearson相关性分析组内及组间比较,差异均有统计学意义(P<0.05)。结论老年全麻手术患者在肌松监测仪监测下行术后拔管,安全可靠。

Objective To observe the safety and efficiency of post-operative extubation under muscle relaxation mo- nitoring in senile patients. Methods 80 senile patients receiving laparoscopic choleeystectomy under general anesthe- sia were selected and randomly divided into 2 groups ： group S （extubation under muscle relaxation monitoring） and D group （extubation based on clinical experience） ; observations were made to MAP, HR, SPO2 at the time point of TO （ before operation）, T 1 （ at extubation）, T 2 （ 15 minutes after extubation） and T 3 （30 minutes after extubation） ; arte- rial blood gas analysis was made at the 4 time points and the values of blood lactic acid （Lac） and SO 2 were recorded, Pearson correlation analysis was then performed. Results The comparison of SPO2 at the time point of Z2 and T3 be- tween the 2 groups showed a statistical difference （ P 〈 0. 05 ） ; Pearson correlation analysis indicated that the intra- group comparison and group comparison of the values of Lac and SO2 were both of statistical difference. Conclusions It is safe and reliable to make extubation under muscle relaxation monitoring in senile patients after oper- ation under general anesthesia.