术后残余肌松的危险因素分析

摘要

Objective To investigate the main risk factors of postoperative residual paralysis,Methods Two hundred and eight patients were enrolled in the study from Peking University People's Hospital The procedure of anesthesia induction and maintenance are in the routine method. After operation,the patients were taken to the post anesthesia care unit (PACU) with tracheal intubation under clinical standards. Muscular strength were tested at the time of extubation. Patients were divided into non-residual paralysis group (TOF-R≥0. 9,n=147)and residual group (TOF-R＜0. 9,n=61)according to train of four (TOF). Twenty-four perioperative variables, 15 variables in operation and 10 post-operative variables of two groups were compared respectively. Results Clinical statistical analysis shown that six clinical variables,including nephrosis, Cr, BUN, hemorrhage, hypotemperature and antagonist had a close relationship with residual paralysi. Conctusion Nephrosis, Cr, BUN, hemorrhage, hypotemperature, antagonist were the main risk factors of postoperative residual paralysis.%目的 探讨术后麻醉恢复室(PACU)中患者残余肌松的主要危险因素.方法 全麻下择期手术患者208例,常规麻醉诱导和维持.术毕在PACU根据临床拔管指征拔除气管导管.拔管后即刻测定肌力恢复情况.根据四个成串刺激比值(TOF-R)将患者分为非残余肌松组(TOF-R≥0.9,n=147)以及残余肌松组(TOF-R<0.9,n=61).分别对两组患者24个术前变量、15个术中变量和10个术毕变量进行比较.结果 各临床指标的统计分析显示患者的肾病病史、血肌酐(Cr)、血尿素氮(BUN),失血量、术中低温、应用肌松拮抗药等6种指标与术后残余肌松密切相关.结论 肾病病史、Cr、BUN、失血量、术中低温、应用肌松拮抗药是术后发生残余肌松的主要危险因素.