在患有骨髓缩侧面硬化症的患者中,苏加马德克斯逆转后的复发:病例报告
Yun-Wen Wang1, Ying Zhang, Xiao Hu
1Department of Anaesthesiology, Peking University First Hospital, Beijing, China.
Medicine
|January 7, 2026
概括
肌缩性侧面硬化症 (ALS) 患者可能会经历延迟的复发后 sugammadex 逆转的罗库. 警监测在输出管后至关重要,以检测ALS患者的潜在呼吸道并发症.
科学领域:
- 麻醉学 麻醉学
- 神经学 神经学
背景情况:
- 肌性侧面硬化症 (ALS) 患者对神经肌肉阻断剂表现出不可预测的敏感性,增加了术后呼吸衰竭风险.
- 苏加马德克斯有效地逆转罗库,但在ALS中延迟的复发是未被认可的.
研究的目的:
- 报告两例ALS患者接受皮肤内镜胃口术的病例.
- 为了突出延迟复发的潜力,尽管在ALS患者的sugammadex逆转.
主要方法:
- 两名女性ALS患者 (67岁和68岁) 经历了穿皮内镜胃口术.
- 麻醉涉及普罗波福和雷米芬坦尼尔; 罗库被逆转了sugammadex,用四列车 (TOF) 比率监测神经肌肉功能.
主要成果:
- 案例1:在苏格玛克斯逆转后的第6个术后日没有意外的恢复和出院 (TOF比率98%).
- 案例2:尽管TOF比率为92%,但在输出管后出现呼吸衰竭,需要重新输入管和重症监护.
结论:
- 在ALS患者中,即使在看似充足的sugammadex逆转后,也可能发生复发.
- 在使用sugammadex用于ALS中的rocuronium逆转时,延长的输出后观察和定量神经肌肉监测是必不可少的.
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