论文部分内容阅读
目的观察不同年龄患者在经皮肾镜手术中体温的变化及体温对顺式阿曲库铵恢复时间的影响。方法选择ASAⅠ~Ⅱ级经皮肾镜手术患者80例,随机分为两组,N组为术中不保温组,H组为术中保温组。再根据年龄将每组患者再分两组,分别为不保温中青年组(NY组)、不保温老年组(NO组)、保温中青年组(HY组)、保温老年组(HO组),每组各20例。采用全身麻醉顺式阿曲库铵0.15 mg/kg诱导气管插管,持续监测肌肉松弛和鼻咽温度,并记录起效时间、拇肌诱导肌颤搐反应(T1)恢复至25%、75%的时间和完全恢复时间(TOFr0.9)及恢复指数(RI)。结果术毕两个不保温组体温显著低于两个保温组(P<0.05),且不保温老人组体温[(34.7±0.4)℃]低于不保温成人组[(35.2±0.3)℃](P<0.05);两个不保温组患者的T125%、75%、RI时间明显长于保温组(P<0.05),不保温老人组起效时间、T125%、75%时间长于不保温成人组(P<0.05)。结论经皮肾镜手术容易发生术中低体温,保温有助于顺式阿曲库铵肌肉松弛作用的恢复,高龄患者尤其应注意保温,避免肌松药残留引起术后并发症。
Objective To observe the changes of body temperature in percutaneous nephrolithotomy patients at different ages and the effect of body temperature on the recovery time of cisatracurium. Methods Eighty ASA Ⅰ ~ Ⅱ patients undergoing percutaneous nephrolithotomy were randomly divided into two groups. N group was intraoperative non-incubation group and H group was intraoperative thermal insulation group. The patients in each group were divided into two groups according to their age: NY group, NY group, NO group, HY group, HO group, Each group of 20 cases. Tracheal intubation was induced by systemic anesthesia with cisatracurium 0.15 mg / kg. Muscle relaxation and nasopharyngeal temperature were continuously monitored and the onset time was recorded. The twitch response (T1) induced by the thumb muscle was restored to 25% and 75% Time and complete recovery time (TOFr0.9) and recovery index (RI). Results The body temperature of two non-incubated groups was significantly lower than that of the two non-insulated groups (P <0.05), and the body temperature of the non-insulated group [(34.7 ± 0.4) ° C] was lower than that of the non-insulated group [(35.2 ± 0.3) (P <0.05). The T125%, 75%, RI of two non-incubation groups were significantly longer than that of the incubation group (P <0.05) (P <0.05). Conclusion Percutaneous nephroscopy is prone to intraoperative hypothermia, which helps to restore the muscle relaxant effect of cisatracurium. In particular, elderly patients should be kept warm to avoid postoperative complications caused by residual muscle relaxants.