杜治昆.不同剂量阿曲库铵对脑肿瘤切除术患者MEP、SEP水平及不良反应的影响研究[J].实用中西医结合临床,2021,21(5):3-6 |
不同剂量阿曲库铵对脑肿瘤切除术患者MEP、SEP水平及不良反应的影响研究 |
Effects of Different Doses of Atracurium on MEP, SEP Changes and Adverse Reactions in Patients with Brain Tumor Resection |
|
DOI: |
中文关键词: 脑肿瘤切除术 阿曲库铵 运动诱发电位 体感诱发电位 不良反应 |
英文关键词: Brain tumor resection Atracurium MEP SEP Adverse reactions |
基金项目: |
|
摘要点击次数: 683 |
全文下载次数: 295 |
中文摘要: |
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T0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T1~T3时刻脑电频指数、呼吸频率较本组T0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T1~T3时刻平均动脉压、心率较本组T0时显著升高,且均显著高于小剂量组;T1~T3时刻脑电频指数、呼吸频率较本组T0时显著降低,且T2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T1~T3时刻平均动脉压、心率较本组T0时刻显著升高,且均显著高于小剂量组,但低于中剂量组;T1~T3时刻脑电频指数、呼吸频率较本组T0时显著降低,且T2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 T3时潜伏期均高于中、小剂量组患者,且N20-P25 T3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。 |
英文摘要: |
Objective: To investigate the effects of different doses of atracurium 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). SpO2 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 higher than that of the low-dose group (P<0.05). The incidence of adverse reactions in small dose group was significantly lower than that in medium-dose group and high-dose group (P<0.05). Conclusion: Low-dose atracurium can reduce the effects on MEP, SEP and propofol dosage on patients with brain tumor resection, and reduce the incidence of adverse reactions during surgery. |
查看全文
查看/发表评论 下载PDF阅读器 |
关闭 |
|
|
|