维库溴铵靶控输主与间断静注临床效果的比较.docVIP

维库漠较靶控输注与间断静注临床效果的比较 唐岩峰，张禾0P,李军 （1温州医学院附属第二医院 麻醉科，浙江 温州325027 ； 2吉林大学附属第 三医院麻醉科，吉林长春132021） ［ ］目的：观察靶控输注技术（TCI）维持肌松可否改变随机静注肌松药的缺 点和不足，从而为临床选出一种科学合理的给药方法。方法：30例拟行胃肠手 术的病人，随机分为两组，C组为间断静注维库漠钱组，对照组，T组为TCI组。 结果：两组病人术毕至气管导管拔管吋间、手术开始及手术刺激最强时Tl/Tc 值及术毕前30分钟内出现体动需要追加镇静或镇痛药病例数差异显著。T组应 用TCI技术可缩短拔管时间（C组为14. 78+11.52, T组为6.67+6.73, P0. 05 =,手术结束前不必因减少给药而引起病人体动或需追加镇痛镇静药物（C组为 8例，T组为0例,P0. 05 = o手术开始及手术刺激最强时Tl/Tc值（C组分别 为 11.25+6.45, 13. 13+9.40； T 组分别为 5.21+3. 23, 5.43+5. 13 , PV0.01 =。 结论：与间断静注比较，静脉TCI泵注维库漠鞍的给药量更准确，肌松水平更恒 定，更容易控制肌松程度，停药后肌松恢复更快，不失为一种科学合理的给药方 法。 ［关键词］维库澳镀，靶控输注，神经肌肉阻滞 ［中图分类号］R614 ［文献标识码］B ［文章编号］ Comparison of target-controlled infusion and intermittent bolus injection of vecuronium Tang Yan-feng*, Zhang He-tiem, Li Jun. * Dcpar tmcnt of Ancst hcsiology, the Seco nd Affiliated Hospital of Wenzhou Medical College, Wenzhou 325027 Abstract: Objective: To examine whether TCI has more advantage than intermittent bolus injection of vecuronim. Method: 30 patient scheduled to undergo abdomi nal surgery were ran doml y al 1 oca ted to t arge t-cont rol 1 ed infusion （T group） or intermittent bolus injeetion （C group）- ResuIt: The total and average amount of the drugs they used also had no statistics differences , but using TCI can shorten the postoperative extubation time obviously （T group 6. 67+6. 73, C group 14. 78+11. 52, p0. 05 = . And before the final, 8 patient in C group moved and required increments of sedatives or analgesics. At the beginning of the operation and the timepoint when the stimulation is the most violent, T group acquired better relaxation （ Tl/Tc T group 5. 21+3. 23, 5. 43+5. 13;C groupll. 25+6. 45, 13. 13+9. 40 , pVO. 01 = ? Conclusion: The lever of neuromuscular block with TCT of vecuronium was stable and easily control 1ed. Clinically it s proved to be a satisfactory technique ? Key words :vecuronium ; Target-controlled infusion; neuromuscular block; TIVA 如何获得满意的肌松程度，维持相对安静的术野，并且避免术后神经肌肉兴 奋传导恢复的延迟，一直是麻醉医师所关注的问题，尤其近年来，维库漠鞍（万 可松）等中效非去极化肌松药广泛应用于临床，由于其作