目的 觀察丙泊酚復合米庫氯銨用于聲帶息肉摘除麻醉的臨床效果和安全性。方法 選擇擇期全麻下行聲帶息肉摘除術患者80例，隨機分為治療組（40例）和對照組（40例）。對照組用丙泊酚2.0 mg/kg、羅庫溴銨1 mg/kg、咪唑安定0.1 mg/kg、芬太尼3 μg/kg誘導后插管，治療組用米庫氯銨0.2 mg/kg代替羅庫溴銨，其他同對照組誘導后插管，計算兩組患者插管時間、手術時間、呼吸恢復時間、呼叫睜眼時間、拔管時間和插管前、插管后、術中、拔管前、拔管后血壓、心率、血氧飽和度的變化情況，同時記錄術后發(fā)生惡心、嘔吐、躁動及圍拔管期不良記憶等不良反應的發(fā)生率。結果 治療組插管時間長于對照組，兩組比較差異有統(tǒng)計學意義（P＜0.05）；治療組呼吸恢復時間、呼叫睜眼時間、拔管時間均明顯短于對照組，兩組比較差異有統(tǒng)計學意義（P＜0.01）。治療組患者拔管前的平均血壓和心率明顯低于對照組，兩組比較差異有統(tǒng)計學意義（P＜0.01）。治療組患者有3例發(fā)生躁動，2例發(fā)生不良記憶，均明顯低于對照組，兩組比較差異有統(tǒng)計學意義（P＜0.05）；兩組患者惡心、嘔吐的發(fā)生率差異無統(tǒng)計學意義。結論 丙泊酚復合米庫氯銨用于聲帶息肉摘除麻醉可以縮短術后拔管時間、減少拔管前血流動力學波動及術后不良反應發(fā)生，二者復合應用安全有效，值得臨床推廣。

Objective To observe the clinical effect and safety of propofol combined with mivacurium in the polyp of vocal cord resection anesthesia. Methods Patients scheduled for polyp of vocal cord resection under general anesthesia (80 cases) were randomly divided into the treatment (40 cases) and control (40 cases) groups. In the control group, the patients were induced with propofol 2.0 mg/kg, rocuronium 1 mg/kg, imidazole valium 0.1 mg/kg, and fentanyl 3 μg/kg; While the patients in the treatment group were induced with mivacurium 0.2 mg/kg instead of rocuronium, and the others were the same as the control group. The time of intubation, operation, respiration, open eyes and extubation were recorded. The MAP, HR and SPO2 of before intubation, after intubation, the period of operation, before extubation and after extubation were recorded. The adverse reactions of nausea, vomit, restless, and bad memory during the perioperation were observed. Results The intubation time of treatment group was more than control group with significant difference (P < 0.05). The time of extubation, respiration and open eyes, adverse reactions, fluctuation of MAP and HR before extubation of treatment group were less than control group with significant difference (P < 0.01). There were three cases restless and two cases bad memory in the treatment group, and the incidences of restless and bad memory were less than control group (P < 0.05). The patients with nausea and vomiting in the two groups had no statistically differences. Conclusion Propofol combined with mivacurium applies in polyp of vocal cord resection anesthesia not only safely, but also can reduce the time of intubation and the adverse reaction, decrease the fluctuation of MAP and HR before extubation, which is worthy to promote the application in clinic.