舒更葡糖钠对逆转介入颅内动脉瘤栓塞术患者肌松拮抗作用的临床研究

Clinical study on the antagonism of muscle relaxation in patients undergoing interventional embolization of intracranial aneurysms with suggenose sodium

目的探讨舒更葡糖钠对逆转介入颅内动脉瘤栓塞术患者术后肌松拮抗的作用和血流动力学的影响。方法选取2020年11月至2021年5月于福建医科大学附属泉州第一医院行介入颅内动脉瘤栓塞术的40例患者。随机分为舒更葡糖钠组(S组)和新斯的明组(N组),每组20例。两组均采用相同麻醉方式,术后S组使用舒更葡糖钠,N组待肌松监测装置(TOFr)=0.4时使用阿托品联合新斯的明。比较两组术前(T0)、术后毕即刻(T1)、术毕5 min(T2)、术毕10 min(T3)、给药后1 min(T4)、给药后5 min(T5)、拔管即刻(T6)、出恢复室即刻(T7)平均动脉压(MAP)、心率(HR),比较两组拔管时间及术后24 h不良反应发生情况。结果两组HR、MAP组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:S组HR各时间点两两比较差异无统计学意义,S组T2、T3、T4、T5、T6、T7 MAP均高于T1,差异有统计学意义(P<0.05);T2、T3、T4、T5、T6、T7,N组HR、MAP均高于T0、T1,差异有统计学意义(P<0.05)。组间比较:T0、T1、T2,两组HR、MAP比较差异无统计学意义,T3、T4、T5、T6、T7,S组HR、MAP均低于N组,差异有统计学意义(P<0.05)。S组拔管时间短于N组,差异有统计学意义(P<0.05)。S组呼吸循环方面(心动过速、低氧血症)不良反应发生率低于N组,差异有统计学意义(P<0.05)。结论舒更葡糖钠用于逆转介入颅内动脉瘤栓塞术患者能有效维持患者血流动力学平稳,缩短拔管时间,降低患者术后心动过速及低氧血症发生率。

Objective To investigate the effect of the antagonism of muscle relaxation in patients undergoing interventional embolization of in-tracranial aneurysms with suggenose sodium and the effect on hemodynamics.Methods 4 cases of patients who underwent interventional emboliza-tion of intracranial aneurysms at the First Hospital of Quanzhou Affiliate to Fujian Medical University from November 2020 to May 2021 were se-lected as the research subjects,and they were randomly divided into the sugammadex group(S group)and the Neostigmine group(N group),with 20 cases in each group.The same anesthesia method was used for both groups.The S group given sugammadex after surgery,while the N group given atropine combined with neostigmine when train-of-four ratio(TOFr)reached 0.4.The mean arterial pressure(MAP)and heart rate(HR)at preoperatively(T0),immediately after surgery(T1),5 min after surgery(T2),10 min after surgery(T3),1 min after administration(T4),5 min after administration(T5),immediately upon extubation(T6),and immediately upon transfer to the recovery room(T7),and the time to extubation and the occurrence of adverse reactions within 24 h postoperatively were compared between the two groups.Results There were significant differences in HR,MAP inter-group,time and interaction between the two groups(P<0.05).Comparison within groups:there was no statistical significance in HR pairwise comparison at each time point in the S group,while T2,T3,T4,T5,T6 and T7 MAP in S group were higher than T1,the differences were statistically significant(P<0.05).At T2,T3,T4,T5,T6 and T7,HR and MAP in the N group were higher than those at T0 and T1,and the dif-ferences were statistically significant(P<0.05).Comparison between groups:at T0,T1 and T2,there was no statistically significant difference in HR and MAP between the two groups;at T3,T4,T5,T6 and T7,HR and MAP in the S group were lower than those in the N group,the differences were statistically significant(P<0.05).The extubation time in the S group was shorter than that in the N group,and the difference was statistically signifi-cant(P<0.001).The incidence if tachycardia,hypoxemia in the N group were higher than those in the S group,and the differences were statistically significant(P<0.05).Conclusion Suggenose sodium can effectively maintain stable hemodynamics,shorten extubation time,and reduce the occur-rence of postoperative tachycardia and hypoxemia in patients undergoing interventional intracranial aneurysm embolization.