肌颤搐用于重症肌无力合并胸腺瘤术中肌松监测的临床研究

目的通过肌颤搐神经肌肉传递功能监测,评价重合并症肌无力胸腺瘤术中临床麻醉的使用价值及安全性。方法 32例ASAⅠ~Ⅲ级合并重症肌无力胸腺瘤患者,根据顺式阿曲库铵诱导用量不同,随机分为0.02mg/kg(A组,n=16)及0.03 mg/kg(B组,n=6)两组。观察并记录患者肌肉松弛效应变化。结果两组患者注射顺式阿曲库铵至肌颤搐100%最大抑制起效时间,无统计学意义(P>0.05);首次肌松药后肌颤搐T1 25%自然恢复时间,B组有显著延长(P<0.05);两组TOF比值(T4/T1)恢复70%的时间,恢复指数(RI)时间,无统计学意义(P>0.05)。结论肌颤搐用于胸腺瘤合并重症肌无力,通过神经肌肉功能监测,有助于全麻肌松调控,保持呼吸功能稳定,防范术后肌松药残留作用以及迟发性呼吸抑制和重症肌无力危象的发生,保障患者生命安全。

Clinical Research of Twitch for Myasthenia Gravis with Thymoma During Surgery Neuromuscular Transmission MonitoringFunction

Objective twitch neuromuscular transmission monitoring function,evaluation of thymoma with myasthenia gravis clinical anesthesia in surgery of use value and safety.Methods 32 patients with ASAⅠ- Ⅲ grade of thymoma with myasthenia gravis patients,according to the cis-atracurium-induced amount of different,randomly divided into 0.02mg.kg-1（A group,n = 16） and 0.03mg/kg（B group,n = 6） groups.Observe and record changes in patients with muscle relaxation effect.Results The two groups of patients after injection of cis-atracurium to twitch 100% maximum inhibition onset time,was not statistically significant（P〉0.05）;the first intravenous injection of muscle relaxants muscle twitch T1 25% spontaneous recovery time,B group was significantly extended（P〈0.05）;Two TOF ratio（T4/T1） to restore 70% of the time,recovery index（RI） time,no statistically significant（P〈0.05）.Conclusion muscle twitching for thymoma with myasthenia gravis,neuromuscular transmission function through monitoring,regulation of muscle relaxant general anesthesia to help maintain respiratory function and stability and prevent postoperative residual effects of muscle relaxants and delayed respiratory depression and severe myasthenic crisis from occurring,ensure patient safety.