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目的:评价舒更葡糖钠拮抗老年患者腹腔镜胃癌根治术后残余肌松的效果。方法:择期全麻下行腹腔镜胃癌根治术患者60例，年龄65～85岁，性别不限，BMI 20～26 kg/mn 2，ASA分级Ⅰ～Ⅲ级，采用随机数字表法分为2组(n n＝30)：舒更葡糖钠组(S组)和新斯的明组(N组)。术中静脉输注罗库溴铵0.3～0.6 mg·kgn -1·hn -1，采用Veryark-TOF监测仪监测肌松，维持TOF比值＝0且强直刺激后计数1或2。关闭腹膜时停用罗库溴铵。术后送入PACU，待肌松监测Tn 2出现时S组静脉注射舒更葡糖钠2 mg/kg，N组静脉注射新斯的明0.03 mg/kg +阿托品0.015 mg/kg。待患者意识及自主呼吸恢复后拔除气管导管。分别于麻醉前(Tn 1)、气管拔管后5和30 min(Tn 2，3)时，抽取动脉血样行血气分析，记录PaOn 2和PaCOn 2，并于上述时点采用超声测量膈肌吸气末厚度、呼气末厚度和膈肌运动幅度，计算膈肌厚度比率。记录Tn 2出现时间、气管拔管时间、PACU停留时间、术后住院时间和气管拔管后30 min内肌松残余(TOF比值<0.9)、低氧血症的发生情况。记录术后7 d内肺部并发症情况。n 结果:与N组比较，S组Tn 2，3时PaOn 2升高，PaCOn 2降低，Tn 2时膈肌运动幅度和膈肌厚度比率升高，气管拔管时间、PACU停留时间和术后住院时间缩短，气管拔管后肌松残余、低氧血症和术后肺部并发症发生率降低(n P0.05)。n 结论:舒更葡糖钠可快速有效地拮抗老年患者腹腔镜胃癌根治术后残余肌松，有利于术后早期恢复。“,”Objective:To evaluate the efficacy of sugammadex for the reversal of residual neuromuscular blockade after laparoscopic radical gastrectomy in elderly patients.Methods:Sixty patients of both sexes, aged 65-85 yr, with body mass index of 20-26 kg/mn 2, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, undergoing elective laparoscopic radical gastrectomy under general anesthesia, were divided into 2 groups (n n=30 each) by a random number table method: sugammadex group (S group) and neostigmine group (N group). Rocuronium 0.3-0.6 mg·kgn -1·hn -1 was intravenously infused during operation, and the muscle relaxation was monitored by a Veryark-TOF monitor, maintaining TOF ratio=0 and counting 1 or 2 after tonic stimulation.Rocuronium was discontinued when the peritoneum was closed.The patients were admitted to the PACU after operation.When the muscle relaxation monitoring Tn 2 appeared, sugammadex 2 mg/kg was intravenously injected in S group, and neostigmine 0.03 mg/kg plus atropine 0.015 mg/kg was intravenously injected in N group.The tracheal tube was removed after the patient′s consciousness and spontaneous breathing recovered.Before anesthesia (Tn 1) and 5 and 30 min after tracheal extubation (Tn 2, 3), arterial blood samples were collected for blood gas analysis, PaOn 2 and PaCOn 2 were recorded, and ultrasound was used to measure the diaphragm end-inspiratory thickness, end-expiratory thickness and mobility of diaphragm muscle at the above time points.The diaphragm thickening fraction was calculated.The time of Tn 2 appeared, time of extubation, time of postanesthesia care unit (PACU) stay, postoperative hospital stay, and residual neuromuscular blockade (TOF ratio <0.9) and hypoxemia occurred within 30 min after extubation were recorded.The pulmonary complications within 7 days after operation were recorded.n Results:Compared with group N, PaOn 2 was significantly increased and PaCOn 2 was decreased at Tn 2, 3, the mobility of diaphragm muscle and diaphragm thickening fraction were increased at Tn 2, the tracheal extubation time, time of PACU stay and postoperative hospital stay were shortened, the residual neuromuscular blockade and hypoxemia occurred after extubation and incidence of pulmonary complications after operation were decreased (n P0.05).n Conclusion:Sugammadex can quickly and effectively reverse the residual neuromuscular blockade after laparoscopic radical gastrectomy, which is helpful for early postoperative recovery in elderly patients.