舒更葡糖钠对老年患者食管癌根治术后肺部并发症的影响

Effect of sugammadex sodium on postoperative pulmonary complications in elderly patients undergoing radical resection of esophageal carcinoma

中文关键词: 老年  食管癌  舒更葡糖钠  新斯的明  术后肺部并发症

英文关键词: elderly  esophageal carcinoma  sugammadex sodium  neostigmine  postoperative pulmonary complication

中文摘要:

      目的 探讨舒更葡糖钠对老年患者食管癌根治术后肺部并发症(PPCs)的影响.方法 通过随机数字表法将2023年4 月—2023 年7 月期间68 例择期行食管癌根治术的老年患者分为观察组(n =34)和对照组(n =34).术毕当四个成串(TOF)刺激计数≥2 时,观察组使用舒更葡糖钠2 mg/kg,对照组使用新斯的明0.05～0.07 mg/kg和阿托品0.015 mg/kg.TOF≥0.9 时拔除气管导管.比较2 组的麻醉时间、手术时间、单肺通气时间、罗库溴铵用量、出血量、尿量、晶体量、胶体量、TOF≥0.9 时间、拔管时间、PACU停留时间及住院时间.评估患者的Richmond躁动—镇静评分(RASS)和Steward评分.记录患者术后第1 天有无发生PPCs和拔管后的不良反应发生情况.结果 与对照组比较,观察组TOF≥0.9 时间和拔管时间较短,差异有统计学意义(P＜0.05).拔管30 min后,2 组RASS和Steward评分无明显差异(P＞0.05).2 组PPCs差异无统计学意义(P＞0.05).与对照组比较,拔管后观察组恶心呕吐较少,差异有统计学意义(17.65%vs 2.94%,P =0.046).结论 舒更葡糖钠能够一定程度快速拮抗肌松残余,减少术后恶心呕吐,但未能减少老年食管癌患者PPCs的发生.

英文摘要:

      Objective To investigate the effect of sugammadex sodium on postoperative pulmonary complications(PPCs)in elderly patients undergoing radical resection of esophageal carcinoma.Methods 68 elderly patients undergoing radical resection of esophageal carcinoma from April2023 to July2023 were divided into observation group(n =34)and control group(n =34)by random number table method.After the operation,when the train of four stimulation(TOF)count was≥2,the observation group was given sugammadex sodium 2 mg/kg,while the control group was given neostigmine 0.05～0.07 mg/kg and atropine 0.015 mg/kg.The endotrachael tube was removed when TOF was≥0.9.The anesthesia time,operation time,one-lung ventilation time,rocuronium dosage,bleeding volume,urine volume,crystal solution volume,colloidal solution vol-ume,time of TOF≥0.9,extubation time,PACU residence time and hospitalization time were compared between the two groups.Patients were assessed by Richmond Agitation-Sedation Scale(RASS)score and Steward score.The occurrence of PPCs and adverse reactions after extubation on the first day after surgery were recorded.Results Compared with the control group,the time of TOF≥0.9 and extubation time were shorted in the observation group,the differences were statistically sig-nificant(P＜0.05).After 30 minutes of extubation,there was no significant difference in RASS and Steward scores between the two groups(P＞0.05).There was no statistically significant difference in PPCs between the two groups(P＞0.05).Compared with the control group,the observation group had fewer cases of nausea and vomiting after extubation,and the difference was statistically significant(17.65%vs 2.94%,P =0.046).Conclusion Sugammadex sodium can quickly antag-onize residual muscle relaxants to a certain extent,reduce postoperative nausea and vomiting,but cannot reduce the incidence of PPCs in elderly patients with esophageal carcinoma after radical operation.