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中国现代手术学杂志  2017, Vol. 21 Issue (1): 65-68    DOI: 10.16260/j.cnki.1009-2188.2017.01.017
  临床论著 |
维库溴铵麻醉诱导对甲状腺手术喉返神经诱发肌电位的影响
张德山
陕西省安康市职业技术学院附属医院麻醉科,安康 725000
The Influence of Anesthesia Induction of Vecuronium Bromide for Recurrent Laryngeal Nerve Electromyography Evocation in Thyroidectomy
ZHANG Deshan
Department of Anesthesiology, Affiliated Hospital of Ankang Vocational Technical College, Ankang 425000, Shaanxi, China
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摘要 目的探讨维库溴铵麻醉诱导对甲状腺手术患者术中喉返神经诱发肌电位的影响。方法 选取2012年3月~2015年3月我院行甲状腺手术患者98例,随机分为三组:甲组患者30例,予0.3 mg/kg维库溴铵麻醉诱导后术中不再追加肌松药;乙组患者30例, 予0.3 mg/kg维库溴铵麻醉诱导, 术中追加肌松药维库溴铵0.3 mg/kg; 丙组患者38例, 予0.6 mg/kg维库溴铵麻醉诱导, 术中追加肌松药维库溴铵0.3 mg/kg。监测三组患者术中喉返神经肌电位。结果三组患者在诱导5 min后(T2)、插管时(T3)、追加肌松药后5 min(T4)、手术结束时(T5)的收缩压(SBP)、舒张压(DBP)和心率(HR)均较麻醉诱导前(T1)降低(P<0.05),但组间比较差异无统计学意义(P>0.05)。各组甲状腺分离前、后喉返神经肌电位比较及三组间比较差异均无统计学意义(P>0.05)。三组患者喉返神经肌电位检测均100%成功,均顺利完成手术操作,无一例因麻醉操作或是用药导致严重不良反应发生。甲组患者中术中肢动率明显高于乙组和丙组患者(P<0.05)。结论甲状腺手术全麻患者应用常规剂量维库溴铵行麻醉诱导,术中追加肌松药,对其喉返神经肌电位检测无影响,且可有效降低术中肢动率,具有较高的临床价值。
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张德山
关键词:  维库溴铵  甲状腺手术  喉返神经监测  肌电位监测    
Abstract: ObjectiveTo investigate the influence of vecuronium induced anesthesia for recurrent laryngeal nerve(RLN) evoked muscle potential in thyroid surgery.MethodsA total of 98 cases underwent thyroid surgery from March 2012 to March 2015 in our hospital were randomly divided into three groups: 30 cases in group A were performed anesthesia induction with 0.3 mg/kg vecuronium and no additional administration with muscle relaxant, 30 cases in group B were given vecuronium 0.3mg/kg for induction of anesthesia and appended muscle relaxant of vecuronium 0.3mg/kg for maintenance of anesthesia, 38 cases in group C were given vecuronium 0.6 mg/kg for anesthesia induction with additional muscle relaxant of vecuronium 0.3 mg/kg.ResultsThe SBP, DBP and HR at T2 (5 min after anesthesia induction), T3 (intubation), T4 (5 min after muscle relaxant administration) and T5 (at the end of surgery) were lower than those before anesthesia induction (T1) in all three groups (P<0.05). There was no statistical difference in SBP, DBP and HR among three groups comparison (P>0.05). No significant difference appeared in the muscle potential amplitude of RLN between before and after the dissection of thyroid in three groups (P>0.05). All cases were detected RLN muscle potential and accomplished the surgery successfully without serious complication. The rate of intraoperative limb movement was higher in group A than that in group B and C (P<0.05).ConclusionThe anesthesia induction with routine dosage vecuronium and muscle relaxant appending in general anesthesia can reduce the limb movement rate and has no effect on RLN muscle potential detection.
Key words:  vecuronium bromide    thyroid surgery    recurrent laryngeal nerve    electromyography
               出版日期:  2017-02-26      发布日期:  2018-05-25      期的出版日期:  2017-02-26
ZTFLH:  R614.2  
作者简介:  张德山,男,40岁,陕西省安康市职业技术学院附属医院麻醉科主治医师。
引用本文:    
张德山. 维库溴铵麻醉诱导对甲状腺手术喉返神经诱发肌电位的影响[J]. 中国现代手术学杂志, 2017, 21(1): 65-68.
ZHANG Deshan. The Influence of Anesthesia Induction of Vecuronium Bromide for Recurrent Laryngeal Nerve Electromyography Evocation in Thyroidectomy. Chinese Journal of Modern Operative Surgery, 2017, 21(1): 65-68.
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http://www.surgerychina.com/CN/10.16260/j.cnki.1009-2188.2017.01.017  或          http://www.surgerychina.com/CN/Y2017/V21/I1/65
[1] 刘红燕, 胡启雅, 王翠萍, 等. 不同剂量罗库溴铵对甲状腺手术喉返神经功能监测的影响[J]. 临床麻醉学杂志,2015,31(5):442444.
[2] 陈鹏, 梁枫, 李龙云, 等. 不同剂量维库溴铵用于麻醉诱导对甲状腺手术患者术中喉返神经监测的影响[J]. 中华麻醉学杂志,2014,34(10):11981200.
[3] 张玉新, 杨程. 定量肌松麻醉对甲状腺手术喉返神经监测的影响[J]. 中国临床研究,2014,27(12):15011503.
[4] 刘红燕. 不同剂量的罗库溴铵复合七氟醚麻醉对于甲状腺手术中喉返神经监测的影响[D]. 山东大学, 2013.
[5] 马志跃, 李彬, 冯勇, 等. 显露喉返神经甲状腺手术对预防喉返神经损伤的影响[J]. 实用医院临床杂志,2016,13(3):8182.
[6] 徐有国, 张丽荣, 曲晓妮, 等. 右美托咪定复合瑞芬太尼+丙泊酚泵注在神经电生理监测甲状腺手术中的应用[J]. 潍坊医学院学报,2015,7(4):315317.
[7] 冯姗姗, 张锦. 利多卡因气管内表麻提高神经探测仪在甲状腺手术中应用的灵敏度[J]. 实用医学杂志,2015,6(11):18421844.
[8] 王铁, 赵诣深, 刘晓莉, 等. 甲状腺术中喉返神经监测系统常见故障及排除[A]. 2014 CTA第三届甲状腺外科高峰论坛暨第五届腔镜甲状腺国际研讨会论文集[C]. 2014:150150.
[9] 吕正华, 徐伟, 邹纪东, 等. 甲状腺手术致双侧喉返神经麻痹的喉返神经减压治疗[J]. 中华耳鼻咽喉头颈外科杂志,2014,49(11):885888.
[10] 邱万寿, 刘威, 吴珏堃, 等. 高风险甲状腺手术中显露喉返神经技术的价值[J]. 中华实验外科杂志,2014,31(11):25512553.
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