摘要
目的:研究不同剂量阿曲库铵对脑肿瘤切除术患者运动诱发电位、体感诱发电位及不良反应的影响。方法:选取2016年6月~2019年6月收治的脑肿瘤切除术患者125例为研究对象,根据使用阿曲库铵剂量不同分为小剂量组40例、中剂量组43例和大剂量组42例。比较三组生命体征情况、麻醉剂用量、麻醉剂血药浓度、运动诱发电位、体感诱发电位及不良反应发生情况。结果:三组患者T_(0)时心率、平均动脉压、脑电频指数、血氧饱和度、呼吸频率比较,无显著性差异(P>0.05)。小剂量组T_(1)~T_(3)时刻脑电频指数、呼吸频率较本组T_(0)即刻显著降低(P<0.05),但心率、平均动脉压无显著性差异(P>0.05)。中剂量组T_(1)~T_(3)时刻平均动脉压、心率较本组T_(0)时显著升高,且均显著高于小剂量组;T_(1)~T_(3)时刻脑电频指数、呼吸频率较本组T_(0)时显著降低,且T_(2)时脑电频指数、呼吸频率显著高于小剂量组(P<0.05)。大剂量组T_(1)~T_(3)时刻平均动脉压、心率较本组T_(0)时刻显著升高,且均显著高于小剂量组,但低于中剂量组;T_(1)~T_(3)时刻脑电频指数、呼吸频率较本组T_(0)时显著降低,且T_(2)时脑电频指数、呼吸显著小于小、中剂量组(P<0.05)。三组各时刻血氧饱和度均无显著性差异(P>0.05)。大剂量组丙泊酚剂量、血清血药浓度均高于中、小剂量组(P<0.05);大剂量组患者引起运动诱发电位留滞时间、运动诱发电位电流强度、N20 T_(3)时潜伏期均高于中、小剂量组患者,且N20-P25 T_(3)时波幅低于中剂量组,但高于小剂量组(P<0.05)。小剂量组不良反应发生率显著低于中、大剂量组(P<0.05)。结论:小剂量阿曲库铵可减少对脑肿瘤切除术患者运动诱发电位、体感诱发电位的影响与丙泊酚使用剂量,从而降低患者术中不良反应发生率。
Objective: To investigate the effects of different doses of atracuri um on motor-and somatosensory-evoked potential(MEP/SEP) changes and adverse reactions in patients with brain tumor resection. Methods: From June 2016 to June 2019 125 Patients undergone brain tumor resection were selected as research subjects, and they were divided into low-dose group(n=40), medium-dose group(n=43) and high-dose group(n=42) according to different doses of atracurium. Changes in vital signs, anesthesia dosage, anesthetic blood concentrations, MEP and SEP, and incidence of adverse reactions were compared between the three groups. Results: There was no significant difference in HR, MAP, BIS, SpO2 and RR between the three groups at T0(P>0.05);compared with indexes at T0, the BIS and RR values at T1~T3 in the low-dose group were significantly decreased(P<0.05), but no significant change was observed in HR and MAP(P>0.05). Compared with indexes at T0, MAP and HR at T1~T3 were increased in medium-dose group, and were higher than those in the low-dose group(P<0.05), meanwhile, the BIS and RR were decreased in medium-dose group at T1~T3(P<0.05), and were significantly higher than those in low-dose group at T2(P<0.05). Compared with indexes at T0, MAP and HR in the high-dose group were increased at T1~T3, and were significantly higher than those in the low-dose group but lower than those in the medium-dose group, meanwhile, the BIS and RR were decreased in high-dose group at T1~T3, and were significantly lower than those in the low-dose group and medium-dose group(P <0.05). Sp O2 had no difference among three groups at each time point(P >0.05). The propofol dosage and serum drug concentration in the high-dose group were higher than those in the medium-dose group and low-dose group(P<0.05). MEP retention time, MEP current intensity and latency of N20 at T3 in the high-dose group were all higher than those in the low-dose group and medium-dose group, meanwhile, the amplitude of N20-P25 at T3 was lower than that of the middle-dose group, but
作者
杜治昆
DU Zhi-kun(Emergency trauma surgery,Nanyang Central Hospital in Henan Province,Nanyang,473009)
出处
《实用中西医结合临床》
2021年第5期3-6,共4页
Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine
