论著
目的 探究新斯的明拮抗顺阿曲库铵的时机对患者腹腔镜结直肠癌根治术后肌松残留和早期肺功能的影响。方法 选取于2021年2月—2022年9月在我院行结肠癌根治手术的194例患者为研究对象,以随机数字表法将患者分为空白对照组和试验组,然后结合给予新斯的明治疗时所体现的4个成串刺激(TOF)比值将试验组患者分为试验组A(TOF≤0.1)、试验组B(0.10.8)。对比组间肌松残余情况以及肺功能情况。结果 插管前,试验组A患者TOF比值低于其他组(P<0.01),空白对照组患者TOF比值高于其他组(P<0.01);空白对照组分别与试验组A~E在复苏室接受观察的时间比较,差异无统计学意义(P>0.01);试验组A患者肌松恢复指数低于其他组(P<0.01),空白对照组患者肌松恢复指数高于其他组(P<0.01)。插管前、拔管0.5 h以及拔管24 h时,组间1秒用力呼气容积(FEV1)、用力肺活量(FVC)和FEV1/FVC比较差异无统计学意义(P>0.05)。结论 结直肠癌根治术后给予新斯的明,有助于加快肌松恢复,但不会影响复苏室停留时间与肺功能水平。
Objective To investigate the effect of timing of neostigmine antagonizing cisatracurium on residual muscle relaxation and early lung function in patients underwent laparoscopic radical resection of colorectal cancer.Methods February 2021 to September 2022,194 patients who underwent radical colon cancer surgery in our hospital were selected as the research subjects.The patients were randomly divided into a blank control group and an experimental group using a random number table method.Then,combined with the train-of-four(TOF)ratios observed during neostigmine treatment,the experimental group patients were divided into experimental group A(TOF≤0.1),experimental group B(0.10.8).The residual muscle relaxation and lung function between groups were compared.Results Before intubation,the TOF ratio of patients in experimental group A was lower than that of other groups(P<0.01),while the TOF ratio of patients in the blank control group was higher than that of other groups(P<0.01).There was no significant difference in the observation time between the blank control group and the experimental group A~E in the postanesthesia care unit(P>0.01).The muscle relaxation recovery index of patients in experimental group A was lower than that of other groups(P<0.01),while the muscle relaxation recovery index of patients in the blank control group was higher than that of other groups(P<0.01).There were no significant differences in force expiratory volume in one second(FEV1),forced Vital capacity(FVC)and FEV1/FVC between groups before intubation,0.5 h after extubation and 24 h after extubation(P>0.05).Conclusions Administration of neostigmine after radical surgery for colorectal cancer can accelerate muscle relaxation recovery,but it will not affect the residence time of the postanesthesia care unit and lung function levels.
论著
目的 分析加速康复外科措施在行腹腔镜辅助结直肠癌根治术治疗患者中的应用价值。方法 2017年6月—2018年8月,选取74例行腹腔镜辅助结直肠癌根治术患者进行研究,按照随机数字表法分为观察组、对照组,对照组实施常规康复外科措施,观察组实施加速康复外科措施,对比两组术后恢复情况、住院情况、应激反应及营养状态。结果 观察组术后首次排气时间、下床活动时间、早期进食时间及导管拔出时间短于对照组(P<0.05);观察组住院时间、总住院费用少于对照组(P<0.05);术前两组患者Hs-CRP(超敏C-反应蛋白)、ALB(白蛋白)、PA(前白蛋白)及Hb(血红蛋白)指标比较,差异无统计学意义(P>0.05)。术后第3 d,观察组Hs-CRP、ALB、PA及Hb指标均优于对照组(P<0.05)。结论 加速康复外科措施在腹腔镜辅助结直肠癌根治术患者中的开展价值显著。
Objective To analyze the value of accelerated rehabilitation surgery in the treatment of patients undergoing laparoscopic assisted radical resection of colorectal cancer. Methods From June 2017 to August 2018, 74 patients who underwent laparoscopic assisted radical resection of colorectal cancer were enrolled in the study. The patients were divided into observation group and control group according to the random number table method. The group implemented accelerated rehabilitation surgery measures to compare postoperative recovery, hospitalization, and immune function. Results The first exhaust time, the time of getting out of bed, the time of early feeding and the time of catheter extraction were shorter in the observation group than that in the control group(P<0.05). The hospitalization time and total hospitalization cost in the observation group were less than those in the control group(P<0.05). There were no significant differences in Hs-CRP(high-sensitivity C-reactive protein), ALB(albumin), PA(pre-albumin) and Hb(hemoglobin) between the two groups before surgery(P>0.05). On the 3rd day after operation, the indexes of Hs-CRP, ALB, PA and Hb in the observation group were better than those in the control group(P<0.05). Conclusion Accelerated rehabilitation surgery is of great value in the development of laparoscopic assisted colorectal cancer radical surgery.