维库溴铵与琥珀胆碱治疗脑外伤张口困难的效果比较及护理
摘要
目的探讨维库溴铵与琥珀胆碱静脉注射治疗脑外伤张口困难的临床效果,并总结其护理经验。方法选择使用维库溴铵的28例患者为观察组,并与28例使用琥珀胆碱的对照组患者比较。结果与对照组比较,观察组插管时和插管后心率较慢、平均动脉压较低,插管时血氧饱和度明显较高(P<0.05);与插管前比较,观察组插管时和插管后平均动脉压明显降低、血氧饱和度明显升高(P<0.05),对照组插管时和插管后平均动脉压明显升高、插管后血氧饱和度也明显升高(P<0.05);观察组可张口时间长于对照组(P<0.05),顺利插管所耗时间短于对照组(P<0.05)。结论对于脑外伤昏迷合并有张口困难的患者,在浅镇静下使用维库溴铵能较好地保持患者循环功能平稳,避免了琥珀胆碱应用后的颅内压升高和肌颤;同时,积极的护理措施对于缩短插管时间有一定帮助。
引文
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[2]Zitkiewicz M,Nestorowicz A.Intraoperative awareness-recommendationsof the Committee on Quality and Safety in Anaesthesia,Polish Society ofAnaesthesiology and Intensive Therapy[J].Anaesthesiol Intensive Ther,2012,44(2):57-62.
[3]Neyens DM,Boyle LN.Crash risk factors related to individuals sustainingand drivers following traumatic brain injuries[J].Accid Anal Prev,2012,49(11):266-273.
[4]Bryson EO,Aloysi AS,Popeo DM.Methohexital and succinylcholine dosingfor electroconvulsive therapy(ECT):actual versus ideal[J].J ECT,2012,28(3):e29-e30.
[5]谢东篱,范丹.维库溴铵预注法对琥珀胆碱肌震颤及术后肌痛的影响[J].四川医学,2007,28(11):1264-1265.
[6]李明祥,刘士红.不同剂量咪唑安定预防全身麻醉患者术中知晓的效果分析[J].中国药业,2009,18(17):67.
[7]Martin-Flores M,Pare MD,Adams W.Observations of the potency andduration of vecuronium in isoflurane-anesthetized horses[J].Vet AnaesthAnalg,2012,39(4):385-389.
[8]安建雄,宋力,林艳君,等.顺式阿曲库铵用于癫痫手术患者的肌松作用[J].江苏医药,2011,31(4):462-464.
[9]曲斌.咪达唑仑与维库溴铵联合注射液同呋塞米注射液存在配伍禁忌[J].中华现代护理杂志,2011,17(31):3 823.
[10]陈岚.严重颌面颅脑外伤患者经鼻盲探气管插管术的配合及护理[J].解放军护理杂志,2010,27(3):212-213.