目的：探讨不同肌松药物对气管插管下全麻手术患者围拔管期残余肌松效应的影响。方法：选取2010年7月-2014年10月期间本院行气管插管下全麻手术治疗的患者176例，依据随机数字表法分为库铵组和对照组，所有患者均给予常规全麻治疗，对照组患者给予0.08~0.12 mg/kg维库溴铵处理，库铵组患者给予0.05~0.10 mg/kg顺式阿曲库铵处理，其中库铵组依据给药方式又分为泵注组和静脉组，统计分析所有患者麻醉前（T0）、麻醉时（T1）、插管（T2）、切皮（T3）、拔管时（T4）的平均动脉压（MAP）和心率（HR），并通过TOF-GUARD监测仪监测围拔管期肌松情况。结果：在T0、T1时，所有患者MAP、HR水平之间比较，差异无统计学意义（P>0.05）；T2、T3、T4时各组MAP、HR水平方面比较，泵注组<静脉组<对照组，差异均有统计学意义（P<0.05）；拔管TOF恢复时间、残余肌松持续时间和发生率方面，泵注组患者明显低于静脉组和对照组，静脉组明显低于对照组，差异均有统计学意义（P<0.05）。结论：顺式阿曲库铵可有效稳定气管插管下全麻手术患者血流动力学波动，有利于抑制患者围拔管期残余肌松效应的发生，其中通过泵注给药方式具有更为良好的效果，值得临床作进一步推广。%Objective:To discuss the effect of different muscle relaxant on residual muscle relaxant effect around the time of perioperative decannulation for patients undergoing endotracheal intubation anesthesia surgery. Method:One hundred and seventy-six patients undergoing endotracheal intubation anesthesia surgery in our hospital from July 2010 to October 2014 were selected and divided into the cis-atracurium group and the control group according to the random number table,88 patients in each group.All the patients were given conventional treatment of general anesthesia,the control group was given 0.08-0.12 mg/kg Vecuronium Bromide,the cis-atracurium group was given 0.05-0.1 mg/kg Cis-atracurium then which were divided into the pump injection group and the intravenous injection group according to the different way of drug-delivery,44 patients in each group.The mean arterial pressure(MAP) and heart rate(HR) of all patients when before the anesthesia(T0),at anesthesia(T1), at intubation(T2),cutting the skin(T3) and the tube drawing(T4) were statistically analyzed,and the muscle relaxant around the time of decannulation were monitored by TOF-GUARD monitoring.Result:At T0 and T1,the MAP and HR levels among all the patients had no significant difference(P>0.05).At T2,T3 and T4,in terms of MAP and HR levels,the pump injection group展开▼
