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不同剂量苯磺顺阿曲库铵对肺癌根治术患者血流动力学及术后认知功能的影响

Effects of different doses of cisatracurium besilate on hemodynamics and postoperative cognitive function in patients undergoing radical resection of lung cancer.

作者信息

Cao Qingxiang, Tian Xiaopeng, Dong Chuanzhen, Bu Huimin, Cheng Yi

机构信息

Department of Anaesthesia, Dongying People's Hospital, Dongying, Shandong 257000, P.R. China.

出版信息

Oncol Lett. 2019 Aug;18(2):1761-1766. doi: 10.3892/ol.2019.10503. Epub 2019 Jun 20.

Abstract

The effects of different doses of cisatracurium besilate on perioperative hemodynamics and early postoperative cognitive function in patients undergoing radical resection of lung cancer were investigated. One hundred and thirty-six patients who underwent radical resection of lung cancer from June 2013 to June 2016 in Dongying People's Hospital were retrospectively analyzed. Patients who were not given atracurium were selected as the control group (n=35). According to the different anesthetic doses, patients in the experimental group were separated into low dose (0.15 mg/kg cisatracurium besilate) group (LD group, n=34), medium dose (0.2 mg/kg cisatracurium besilate) group (MD group, n=36) and high dose (0.3 mg/kg cisatracurium besilate) group (HD group, n=31). The mean arterial pressure and heart rate (HR) were recorded before induction of anesthesia (T0), at the time of entering pleural cavity (T1), at the end of surgery (T2), and 1 day after surgery (T3). The Mini-Mental State Examination (MMSE) was used to evaluate the postoperative cognitive function scores of the 4 groups 1 day before operation and on the 1st, 3rd and 7th day after surgery. The agitation of patients at 6 and 12 h after operation was evaluated by Ramsay sedation score. There was no significant difference in arterial pressure among the four groups at T2 and T3 (P>0.05). There was no significant difference in terms of MMSE among the four groups 1 day before operation, 3 days after operation and 7 days after operation, but the MMSE score of the control group was significantly lower than that of the LD, MD and HD groups 1 day after surgery (P<0.05). Therefore, cisatracurium besilate can stabilize hemodynamics during radical operation of lung cancer and reduce the incidence of postoperative cognitive dysfunction, and it has no close association with the dose.

摘要

探讨不同剂量苯磺顺阿曲库铵对肺癌根治术患者围手术期血流动力学及术后早期认知功能的影响。回顾性分析2013年6月至2016年6月在东营市人民医院行肺癌根治术的136例患者。未给予阿曲库铵的患者作为对照组(n = 35)。根据麻醉剂量不同,将实验组患者分为低剂量(0.15 mg/kg苯磺顺阿曲库铵)组(LD组,n = 34)、中剂量(0.2 mg/kg苯磺顺阿曲库铵)组(MD组,n = 36)和高剂量(0.3 mg/kg苯磺顺阿曲库铵)组(HD组,n = 31)。记录麻醉诱导前(T0)、进入胸腔时(T1)、手术结束时(T2)及术后1天(T3)的平均动脉压和心率(HR)。采用简易精神状态检查表(MMSE)评估4组患者术前1天及术后第1、3、7天的术后认知功能评分。采用Ramsay镇静评分评估术后6 h和12 h患者的躁动情况。4组患者在T2和T3时动脉压差异无统计学意义(P > 0.05)。4组患者术前1天、术后3天和术后7天的MMSE差异无统计学意义,但术后1天对照组的MMSE评分显著低于LD组、MD组和HD组(P < 0.05)。因此,苯磺顺阿曲库铵可稳定肺癌根治术中的血流动力学,降低术后认知功能障碍的发生率,且与剂量无密切关联。

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