| 摘要: |
| ［摘要］ 目的 评价舒更葡糖钠对老年患者胸腔镜肺癌根治术后肺部并发症(PPCs)的影响。方法 选择2020年2月至2020年7月于河南省胸科医院择期拟行胸腔镜肺癌根治术的老年患者100例，采用随机数字表法将其分为舒更葡糖钠组和新斯的明组，每组50例。术毕时，舒更葡糖钠组待四个成串刺激(TOF)计数≥2时予静脉注射舒更葡糖钠2 mg/kg；新斯的明组待患者有自主呼吸时静脉注射新斯的明40 μg/kg+阿托品10 μg/kg。比较两组患者术后72 h内的PPCs发生率。采用康复质量评分量表-15(QoR-15)评估患者术后第1天、第2天的康复质量。观测两组患者术前1 d、术后第1天和第3天时的炎症指标。比较两组手术相关指标、麻醉后恢复室(PACU)停留时间、术后住院时间等。结果 新斯的明组术后72 h内发生PPCs 15例（30.00%），舒更葡糖钠组6例（12.00%），差异有统计学意义(χ2=4.883，P=0.027)。两组术后白细胞计数、中性粒细胞计数和中性粒细胞百分比水平均呈上升趋势，且舒更葡糖钠组上升幅度更小（P<0.05）。在术后第1天、第3天，舒更葡糖钠组白细胞计数、中性粒细胞计数和中性粒细胞百分比水平均显著低于新斯的明组（P<0.05）。舒更葡糖钠组术后PACU停留时间和术后住院时间均较新斯的明组短，差异有统计学意义（P<0.05）。新斯的明组窦性心动过缓、口干和恶心呕吐的发生率显著高于舒更葡糖钠组（P<0.05）。舒更葡糖钠组在术后第1天和第2天的QoR-15评分均高于新斯的明组，差异有统计学意义（P<0.05）。结论 舒更葡糖钠可降低胸腔镜肺癌根治术后老年患者的PPCs发生率，有利于其早期康复。 |
| 关键词: 舒更葡糖钠 胸腔镜手术 肺癌 老年患者 术后肺部并发症 |
| DOI：10.3969/j.issn.1674-3806.2022.05.02 |
| 分类号:R 614 |
| 基金项目:河南省医学科技攻关计划联合共建项目（编号：2018020564） |
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| Effect of sugammadex sodium on pulmonary complications after thoracoscopic radical resection of lung cancer in elderly patients |
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WANG Xiao-jing, XIE Ya-xian, DANG Xiao-yan, et al.
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Department of Anesthesiology, Henan Provincial Chest Hospital, Zhengzhou 450008, China
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| Abstract: |
| ［Abstract］ Objective To evaluate the effect of sugammadex sodium on postoperative pulmonary complications(PPCs) after thoracoscopic radical resection of lung cancer in elderly patients. Methods One hundred elderly patients who underwent elective thoracoscopic radical resection of lung cancer in Henan Provincial Chest Hospital from February 2020 to July 2020 were selected and divided into sugammadex sodium group and neostigmine group by random number table method, with 50 cases in each group. At the end of the operation, the sugammadex sodium group was given intravenous injection of sugammadex sodium 2 mg/kg when the counts of train-of-four stimulation(TOF) were more than or equal to 2 and the neostigmine group was given neostigmine 40 μg/kg+atropine 10 μg/kg intravenously when the patients had spontaneous breathing. The incidence of PPCs within 72 h after surgery was compared between the two groups. The 15-Quality of Restoration(QoR-15) was used to evaluate the quality of rehabilitation of the patients on the first day and the second day after surgery. The inflammatory indicators of the patients in the two groups were observed on the first day before surgery, and on the first day and the third day after surgery. The operation-related indicators, the stay time in the postanesthesia care unit(PACU), and the postoperative hospital stay were compared between the two groups. Results There were 15 cases(30.00%) of PPCs in the neostigmine group and 6 cases(12.00%) in the sugammadex sodium group within 72 hours after surgery, and the difference was statistically significant(χ2=4.883, P=0.027). The levels of white blood cell count, neutrophil count and neutrophil percentage showed an upward trend in the two groups after surgery, and the increases in the sugammadex sodium group were smaller than those in the neostigmine group(P<0.05). On the first day and the third day after surgery, the white blood cell count, neutrophil count and neutrophil percentage in the sugammadex sodium group were significantly lower than those in the neostigmine group(P<0.05). The postoperative stay time in PACU and postoperative hospital stay in the sugammadex sodium group were shorter than those in the neostigmine group, and the differences were statistically significant(P<0.05). The incidence rates of sinus bradycardia, dry mouth and nausea and vomiting in the neostigmine group were significantly higher than those in the sugammadex sodium group(P<0.05). The QoR-15 scores of the sugammadex sodium group on the first day and the second day after surgery were higher than those of the neostigmine group, and the differences were statistically significant(P<0.05). Conclusion Sugammadex sodium can reduce the incidence of PPCs in elderly patients after thoracoscopic radical resection of lung cancer, which is beneficial to their early rehabilitation. |
| Key words: Sugammadex sodium Thoracoscopic surgery Lung cancer Elderly patients Postoperative pulmonary complications(PPCs) |
