上海交通大学学报(医学版) ›› 2023, Vol. 43 ›› Issue (1): 108-113.doi: 10.3969/j.issn.1674-8115.2023.01.014
• 综述 • 上一篇
收稿日期:
2022-05-14
接受日期:
2022-11-03
出版日期:
2023-01-16
发布日期:
2023-01-16
通讯作者:
翁晓建
E-mail:liuqiuly@sjtu.edu.cn;jxw1860@163.com
作者简介:
刘秋利(1997—),女,硕士生;电子信箱:liuqiuly@sjtu.edu.cn。
基金资助:
LIU Qiuli(), JIANG Lai, WENG Xiaojian()
Received:
2022-05-14
Accepted:
2022-11-03
Online:
2023-01-16
Published:
2023-01-16
Contact:
WENG Xiaojian
E-mail:liuqiuly@sjtu.edu.cn;jxw1860@163.com
Supported by:
摘要:
肌肉松弛(肌松)药诱导的肌肉松弛是手术中气管插管和固定的重要条件之一,术后未完全逆转肌松药效应称为术后肌松残余(postoperative residual neuromuscular block,PRNB)。PRNB可引发患者一系列严重的术后并发症甚至死亡,因此在麻醉实施过程中对其进行早期预防及积极治疗必不可少。随着外科技术飞速发展及人口平均寿命逐渐延长,老年患者的手术需求逐渐增多。与此同时,由于老年患者机体的生理病理变化及合并的基础疾病,其更易发生不同程度的PRNB,可严重损害患者的预后以及增加医疗资源的损耗。近年来,各类短效肌松药和新型拮抗剂(如舒更葡糖钠)等的问世,以及术中肌松监测的临床应用,已经明显降低了年龄相关PRNB所致不良事件的发生率,彻底改变了麻醉实践。同时,以神经肌肉接头结构为主导的基础研究,以及针对老年患者的药代动力学和药效动力学研究,也为降低PRNB对老年患者的危害提供了新的理论依据。该文对临床上老年患者全身麻醉手术后发生PRNB的原因机制、引发的不良事件及临床干预措施的研究进展作一综述,以期为老年患者全身麻醉的肌松管理及术后拮抗提供参考。
中图分类号:
刘秋利, 江来, 翁晓建. 老年患者全身麻醉术后肌松残余的研究进展[J]. 上海交通大学学报(医学版), 2023, 43(1): 108-113.
LIU Qiuli, JIANG Lai, WENG Xiaojian. Progress of residual neuromuscular blockade after general anesthesia in elderly patients[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(1): 108-113.
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