摘要
目的:观察老年人与青壮年在肌松监测指导气管拔管时和在临床评估指导气管拔管时的血流动力学变化和术后肌松残余(PORC)的发生率。方法:80例择期全麻患者,根据病人年龄分为4组:老年组(年龄65～80岁:其中A1组为临床评估指导气管拔管组,B1组为肌松监测指导气管拔管组)和青壮年组(年龄18～55岁:相同方法分为A2、B2组),每组20例。全麻后A1、A2组在患者呼之睁眼、抬头5秒、握拳有力时气管拔管;B1、B2组在TOF值(四个成串刺激比率)恢复至0.9时拔气管导管。结果:A1与B1组MAP,HR无明显差异(P>0.05),B2的MAP,HR变化比A2组显著(P<0.05),B2组MAP,HR变化比B1组显著(P<0.05),A1组拔管后1小时的肌松残余(PORC)发生率30%,B1组5%;A2组拔管后1小时的PORC发生率5%,B2组0%。结论:在肌松监测下气管拔管,老年人较青壮年循环稳定,术后肌松残余(TOF<0.9)发生率明显减少,对于老年患者具有临床应用价值。
Objective：Observation the old and prime of life in monitoring of muscle relaxation in clinical monitoring the guidance of tracheal extubation.The hemodynamics and the postoperative residual curarizationmuscle（PORC） the rate.Methods：Choice of 100 eases of patients,according to the patient is divided into four age groups.Elderly group（age 65-80 years old,A1 group for the clinical supervision tracheal extubation,Bl groups of muscle relaxation and guidance of the tracheal extubation）.Prime of life group（age 18-55 years old,use the same method divided into groups, A2, B2）,group of 20 cases.A1,A2 group at call when he opened his eyes,up to five seconds,shook hands are strength tracheal extubation.Bl ~ B2 group at TOF〉0.9 tracheal extubation.Results：Al B1 group MAP,HK ao obvious diffcrences（P〉0.05）,B2 group MAP, HR changes were significant compared with A2（P〈0.05）,B2 group MAP, HR changes were significant compared with BI（P〈0.05）,AI group after extubation 1 hour of PORC incidence of 30% and BI group of 5%;A2 group after extubation 1 hour of PORC incidence of 5% and B2 group of 0%.Conclusion：The old and young people are muscle relaxation and guidance of the tracheal extubation.The aged circulatory stability,TOF〈0.9 rate has dropped, have value in clinical.
出处
《中国医药导刊》
2010年第12期2021-2022,共2页
Chinese Journal of Medicinal Guide
基金
上海市嘉定区科技发展基金资助项目(2007JKK020)
