罗库溴铵治疗发绀型先天性心脏病药效研究

Drug efficacy study of rocuronium in treatment of children with cyanotic congenital heart disease

目的:探讨罗库溴铵在发绀型先天性心脏病患者临床治疗中的量效关系和时效关系。方法:选择2014年2月至2016年2月在我院就诊的60例先天性心脏病患者作为研究对象,其中发绀型先天性心脏病患者30例(A组),非发绀型先天性心脏病患者30例(B组),另选取同期收治的行手术治疗的非心脏病患者30例作为对照(C组)。研究分为两部分:(1)量效关系研究。从A组、B组、C组中各抽取15例患者,采用单次给药技术建立罗库溴铵量效关系曲线,分别计算各组ED_(50)和ED_(95)。(2)时效关系研究。将A组、B组、C组中其余的15例患者静脉注射罗库溴铵600μg/kg后,记录起效时间、作用时间和恢复时间。结果:A组患者的ED_(50)和ED_(95)显著性大于B组和C组(P<0.05),且B组患者的ED_(50)和ED_(95)显著性大于C组(P<0.05)。A组的起效时间显著性长于B组与C组(P<0.05),而3组作用时间和恢复时间比较则无显著性差异(P>0.05)。结论:发绀型先天性心脏病患者使用罗库溴铵的ED_(50)和ED_(95)较大,敏感性差,且起效慢,因此应在术中全程检测肌松水平,实施个体化给药方案。

Objective： To investigate the dose-effect relationship and time-effect relationship of rocuroniumchildren with cyanotic congenital heart disease. Methods： From February 2014 to February 2016 in our hospital,60 children withcongenital heart disease were enrolled as the research objects,including 30 cases of cyanotic congenital h30 cases of non-cyanotic congenital heart disease （group B）; other 30 children without heart dduring the same period were selected as control group （ group C）. （ 1 ） Dose-effect relationship study： 15 children were selected from each group; the dose-effect curve of rocuronium was established by single-dose technique,and the ED5 0 and ED9 5 of each group were calculated respectively. （2） Time-effect relationship study： the remaining 15 cases of each group were givenrocuronium 600 ^g/kg by intravenous injection,and the onset time,action time and reED50 and ED95 of rocuronium in group Awere significantly higher than those in group B and group C（P 〈0. 05 ）,and the ED5 0 andED95 in group B were significantly higher than those in group C （P〈 0. 05 ）. The onset time in group Awas significantly longer thanthat in group Band C（P 〈0. 05 ）,and there were no significant differences in the action time and recovery time among the threegroups（P 〉0. 05）. Conclusion： Rocuronium in the treatment of children with cyanotic congenital heart dand ED95 ,poor sensitivity and slow onset. Therefore,the muscle relaxation level should be detected during the whole process ofoperation,and individualized dose regimen should be implemented.