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急性等容量血液稀释对顺式阿曲库铵作用时效的影响

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DOI:
作者:
余亮
Yu Liang
作者单位:
浙江湖州市中心医院
Zhejiang Huzhou Central Hospital
关键词:
血液稀释；自体；输血；顺式阿曲库铵?
Hemodilution;Blood transfusion, autologous; Cisatracurium
摘要:
摘要：目的 探讨急性等容量血液稀释（ANH）对单次插管剂量3倍95%有效剂量（3ED95）的顺式阿曲库铵肌松作用时效的影响。方法 将40例择期手术患者随机分为实验组（ANH组）和对照组（C组），每组各20例。ANH组麻醉诱导前行ANH，C组未做特殊处理。记录C组和ANH组患者入手术室后即刻及ANH组实施ANH后的红细胞比容（Hct）、血红蛋白浓度（Hb）、电解质（K+、Na+、Ca2+）浓度和清蛋白（Alb）、总蛋白（TP）的血清含量；以肌松监测仪监测顺式阿曲库铵肌松起效时间、无反应期、阻滞维持时间和肌松恢复时间，同时记录气管插管条件。结果 ANH组实施ANH后Hct、Hb、K+、Na+、Ca2+、Alb、TP均明显降低（P<0.05）；与C组相比，ANH组单次插管剂量的顺式阿曲库铵肌松起效时间明显缩短（P<0.05），无反应期、阻滞维持时间、肌松恢复时间、气管插管条件没有显著差异（P>0.05）。结论 ANH使单次插管剂量的顺式阿曲库铵肌松起效时间缩短，对无反应期、阻滞维持时间、肌松恢复时间和气管插管条件没有明显影响。
Objective To investigate the effect of acute normovolemic hemodilution(ANH) on the onset-duration-recovery profile of 　3×ED95 cisatracurium in patients undergoing neurosurgery. Methods Forty American Society of Anesthesiologists(ASA)I-II patients undergoing neurosurgery were randomized into group ANH (ANH before anesthesia induction ,n=20) and group C(without ANH, n=20).Arterial and central venous blood samples were drawn for analysis of hematocrit(Hct) ,hemoglobin(Hb), electrolytes(K+,Na+,Ca2), albumin(Alb) and total protein(TP) according to preset time points.Neuromuscular function was assessed using a train-of-four stimulation(TOF). Onset time, peak effect time, duration of action, and recovery time were recorded and the intubation conditions were evaluated.Results The Hct, Hb, K+, Na+, Ca2+, Alb, TP were significantly descended after the group ANH preformed ANH（P<0.05）.The group ANH’s onset time was significantly shorter than group C（P<0.05）.There was no significant difference in peak effect time, duration of action, recovery time and the intubation conditions between the two groups（P>0.05）.Conclusions Due to the ANH, the Hct, Hb, K+, Na+, Ca2+, Alb, TP were descended and the onset time of cisatracurium were shortened , but the peak effect time, duration of action, recovery time and the intubation conditions were not affected by ANH.

 

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