不同剂量5-HT_3受体拮抗剂托烷司琼对全麻术后恶心呕吐的影响的临床研究  

Effects of Tropisetron on PONV after upper abdominal surgery

作　　者：徐康清[1] 王彪[1] 黄文起[1] 何广芬[1] 江南[1] 李冬菊[1] 

机构地区：[1]中山大学附属第一医院麻醉科,广州市510080

出　　处：《国外医学（麻醉学与复苏分册）》2005年第1期1-3,共3页Foreign Medical Sciences(Anesthesilolgy and Resuscitation)

摘　　要：目的　观察不同剂量的5 -HT3 受体拮抗剂托烷司琼(Tropisetron)对术后恶心呕吐(PONV)的作用时效,以寻求一种比较理想的止吐药物及合适的剂量预防和减少PONV的发生。方法　择期上腹部吸入全麻手术患者12 0例,随机双盲分成生理盐水对照组(A组) ,恩丹西酮8mg组(B组) ,托烷司琼2mg(C组)及5mg(D组) ,每组各30例。术毕观察给止吐药至第1次出现恶心呕吐的时间、各组发生恶心、呕吐的病人数、接受补救药物的病人数、恶心的严重程度、病人对止吐药物的满意度、头晕头痛、椎体外系症状等副作用。结果　各组病人性别、体重、年龄、麻醉持续时间、术中生命体征等各组间比较差异无显著性(P >0 0 5 )。各组发生恶心、呕吐和接受补救药物病人数,初次出现恶心的时间,恶心严重程度评分的比较中,托烷司琼均优于恩丹西酮,P <0 0 5 ;托烷司琼2mg及5mg头晕头痛的发生率相近,均低于恩丹西酮,P <0 0 5。结论　①托烷司琼的镇吐效果优于恩丹西酮。②托烷司琼2mg不仅可以减少药物用量、增强抗吐时效,而且能减少副作用的发生,是一种经济、有效、安全且值得推广应用的止吐方法。Objective To study the effects of Tropisetron on PONV after upper abdominal surgery.Methods 120 Patients, ASA score I-II, scheduled for elective upper abdominal surgery were randomly allocated into four groups: Normal saline study group (group A), group Ondanstron (group B), group Tropisetron of 2mg (group C), group Tropisetron of 5mg (group D). The time course between drug administration and the first time of PONV, the numbers of patients with PONV, the scores of PONV and side effets were studied respectively. Results The time course between drug administration and the first time of PONV, the numbers of patients with PONV, the scores of PONV and side effets in group Tropisetron were respectively lower than those in group Ondanstron(P<0.05). Group C had the same rate of side effects as group D,but it was less than that in group B. Conclusion Compared with Ondanstron, Tropisetron was a better anti-PONV agent. Tropisetron of 2mg had the better efficacy and less side effects on preventing PONV of upper abdominal surgery.

关 键 词：5-HT3受体拮抗剂 术后恶心呕吐 托烷司琼 不同剂量 临床研究 恩丹西酮 椎体外系症状 严重程度评分 止吐药物 0.05 作用时效 PONV 手术患者 吸入全麻 生理盐水 随机双盲 持续时间 生命体征 药物用量 止吐方法 推广应用 

分 类 号：R614[医药卫生—麻醉学]