摘要
目的探讨不同肌松拮抗方式对腹腔镜下胆囊切除患者术后恢复的影响。方法本研究纳入2023年10月-2024年10月在本院接受腹腔镜下胆囊切除术的96例患者,按照前瞻性随机对照临床试验设计,将患者随机分为实验组和对照组,每组48例。实验组在神经肌肉监测仪引导下给予新斯的明;对照组则在手术结束时给予常规剂量新斯的明。比较两组不同时间肌松残余、呼吸及循环功能、心血管功能、超声测量膈肌厚度及变化率等指标变化。结果实验组术后即刻、术后1小时及术后6小时T1恢复率均高于对照组(P<0.05),实验组潮气量大于对照组(P<0.05),呼吸频率低于对照组(P<0.05),动脉血氧饱和度高于对照组(P<0.05),心率慢于对照组(P<0.05),收缩压和舒张压低于对照组(P<0.05),实验组膈肌厚度变化率大于对照组(P<0.05),实验组并发症发生率低于对照组(P<0.05),拔管时间和PACU停留时间短于对照组(P<0.05),满意度高于对照组(P<0.05)。结论神经肌肉监测仪引导下给予新斯的明拮抗,可有效指导肌松拮抗,快速促进患者麻醉恢复,提高患者麻醉舒适度。
Objective To explore the effects of different muscle relaxation antagonism methods on postoperative recovery in patients undergoing laparoscopic cholecystectomy.Methods This study included 96 patients who underwent laparoscopic cholecystectomy in our hospital from October 2023 to October 2024.According to a prospective randomized controlled clinical trial design,the patients were randomly divided into an experimental group and a control group,with 48 patients in each group.The experimental group was given neostigmine under the guidance of a neuromuscular monitoring device;the control group was given a regular dose of neostigmine at the end of the surgery.Compare the changes in indicators such as residual muscle relaxation,respiratory function,cardiovascular function,diaphragm thickness and rate of change measured by ultrasound between two groups at different times.Results The T1 recovery rate in the experimental group was higher than that in the control group immediately after surgery,1 hour after surgery,and 6 hours after surgery(P<0.05),the tidal volume of the experimental group was higher than that of the control group(P<0.05),the respiratory rate was lower than that of the control group(P<0.05),the arterial oxygen saturation was higher than that of the control group(P<0.05),the heart rate was slower than that of the control group(P<0.05),the systolic and diastolic blood pressure were lower than that of the control group(P<0.05),the rate of change in diaphragm thickness in the experimental group was higher than that of the control group(P<0.05),the incidence of complications in the experimental group was lower than that of the control group(P<0.05),the extubation time and PACU retention time were shorter than those in the control group(P<0.05),and satisfaction was higher than that in the control group(P<0.05).Conclusion Under the guidance of a neuromuscular monitor,administration of neostigmine antagonist can effectively guide muscle relaxation reversal,rapidly promote patient anesthesia recovery,and improve patient anesthesia comfort.
作者
彭刚
赵迪舟
房蕾
李涵葳
Peng Gang;Zhao Dizhou;Fang Lei;Li Hanwei(Shantou University School of Medicine,Shantou,Guangdong 515041,China;Shenzhen People’s Hospital,Shenzhen,Guangdong 518000,China)
出处
《首都食品与医药》
2025年第14期29-31,共3页
Capital Food Medicine
关键词
神经肌肉监测仪
新斯的明
肌松拮抗
腹腔镜
胆囊切除
Neuromuscular monitoring device
Xin Siming
Muscle relaxation antagonism
laparoscope
cholecystectomy
作者简介
通信作者:李涵葳,邮箱:734285800@qq.com。
