托烷司琼用于预防神经外科术后恶心呕吐的研究  

Effect of Tropisetron on Postoperative Nausea and Vomiting in Patients Undergoing Neurosurgery

作　　者：李红玲[1] 彭昆[1] 韩如泉[1] 王保国[1] 

机构地区：[1]首都医科大学附属北京天坛医院麻醉科,100050

出　　处：《天津医药》2006年第8期550-552,共3页Tianjin Medical Journal

摘　　要：目的:观察5-HT3受体拮抗剂盐酸托烷司琼与盐酸恩丹西酮预防神经外科开颅术患者术后恶心呕吐(PONV)的有效性和安全性。方法:选择神经外科行幕上开颅手术患者150例,随机分为3组:盐酸托烷司琼组、盐酸恩丹西酮组和空白对照组,每组50例。各组于手术至缝合硬膜时分别静脉滴注盐酸托烷司琼5mg,盐酸恩丹西酮4mg及注射用水。术后中、重度呕吐患者追加使用抗呕吐药物盐酸恩丹西酮。术后观察并记录以下指标:(1)恶心发生率。(2)呕吐发生率。(3)疼痛视觉模拟评分(VAS)。(4)镇静评分(OAA/S)。(5)平均动脉压(MAP)、心率(HR)。(6)追加使用抗呕吐药物的药名及剂量。(7)不良反应的发生情况。结果:术后2h内托烷司琼组、恩丹西酮组恶心及呕吐的发生率低于对照组(P<0.01或P<0.05);但两治疗组间差别无统计学意义(P>0.05)。恩丹西酮组术后24h内恶心的发生率较托烷司琼组呈增加趋势,但差异无统计学意义(χ2=3.326,P>0.05)。结论:托烷司琼、恩丹西酮均可降低恶心呕吐的发生率。托烷司琼作用时限较恩丹西酮长,可能具有更好的预防效果。Objective; To evaluate the safety and efficacy of 5-HT3 receptor antagonist tropisetron in preventing postoperative nausea and vomiting （PONV） in patients undergoing selective craniotomy. Methods： One hundred and fifty patients were randomly allocated 3 groups： tropisetron group （group A, n = 50, tropisetron 5 mg）, ondansetron group （group B, n = 50, ondansetron 4 mg） and placebo group （group C, n = 50, saline 10 mL）. The drugs were administered intravenously at the time of dural closure respectively. Episodes of nausea and vomiting were recorded at 2 h, 4 h, and 24 h respectively. Results： The incidence of nausea and vomiting was significantly lower in group A and B than that in group C within 2 h postoperatively （P〈0.01）, while there was no significant difference between group A and group B. Frequency of nausea showed an enhancive tendency in group B compared with group A at 24 h postoperatively while there was no significant difference between the two groups （P〉0.05）. Conclusion： Prophylactic tropisetron or ondansetron can reduce the incidefice of PONV in patients undergoing neurosurgery. Tropisetron has a longer-acting activity and might have better efficacy on PONV compared with that of ondansetron.

关 键 词：吲哚类 昂丹司琼 手术后恶心呕吐 神经外科手术 

分 类 号：R442.1[医药卫生—诊断学] R975.4[医药卫生—临床医学]