【摘要】 全身麻醉常使用肌肉松弛药物以满足插管和手术需求,术毕患者恢复意识及自主呼吸后应及时拔除气管内导管。然而,神经肌肉阻滞剂的残余作用会降低气管导管拔除的成功率。同时,残余肌松会增加术后低氧血症、反流误吸等呼吸并发症的发生。因而,判断肌松恢复尤为重要。四个成串刺激是常用肌松监测方法,但因其价格昂贵、引起患者不适等缺点,尚未在临床中大量普及。膈肌是主要呼吸肌,且抵抗肌松药能力最强,通过监测膈肌功能可预测拔管结局。超声克服传统监测膈肌方法所存在的有创、电离辐射、成本高等不足问题,使其成为膈肌成像的替代方法,用于监测膈肌功能、预测拔管结局,指导拔管时机。更多还原

【Abstract】 Muscle relaxants are often used in general anesthesia to meet the needs of intubation and operation. The endotracheal catheter should be removed in time when the patient regained consciousness and breathed spontaneously after the operation. However, the residual effect of neuromuscular blocking agents can reduce the success rate of endotracheal extubation. Besides, residual muscle relaxation will increase the occurrence of respiratory complications such as hypoxemia, reflux aspiration and so on. Therefore, it is particularly important to judge the recovery of muscle relaxation. The train-of-four stimulation is commonly used, yet has not been widely practiced in the clinic for its expensiveness and discomfort to patients. Being the main respiratory muscle, the diaphragm has the strongest resistance to muscle relaxants, which makes it possible to predict the extubation outcome by monitoring the diaphragm function. Overcoming the drawbacks of traditional diaphragm monitoring methods, such as invasiveness, ionizing radiation, and expensiveness, ultrasound has become the alternative method for diaphragm imaging in monitoring diaphragm function, predicting extubation outcome and guiding the timing of extubation.更多还原