几种药物预防腹腔镜胆囊切除术后恶心呕吐的对比研究  

To compare the prophylactic effect of granisetron, droperidol, dexamethasone and droperidol plus dexamethasone on postoperative nausea and vomiting after laparoscopic cholecystectomy

作　　者：李军[1] 段思源[1] 上官云芳 姚颖[1] 

机构地区：[1]上海市中西医结合医院麻醉科,200082

出　　处：《临床麻醉学杂志》2007年第5期369-370,共2页Journal of Clinical Anesthesiology

摘　　要：目的比较格拉司琼、氟哌利多、地塞米松单用或合用预防腹腔镜胆囊切除术后恶心呕吐的效果。方法择期腹腔镜胆囊切除术患者160例,于麻醉前随机分为四组,静脉注入各预防性药物,A组:地塞米松10mg;B组:氟哌利多2.5mg;C组:氟哌利多2.5mg+地塞米松10mg;D组:格拉司琼3mg。观察术后24h恶心呕吐发生率。结果四组术后24h恶心呕吐总发生率分别为78%、63%、25%、28%,C组和D组明显低于A组和B组(P<0.01),而C组与D组差异无统计学意义。结论格拉司琼、氟哌利多、地塞米松都有预防腹腔镜胆囊切除术后恶心呕吐的作用,但以格拉司琼和氟哌利多+地塞米松效果显著,而且氟哌利多+地塞米松更显示其性价比优越性。Objective To compare the prophylactic effect of granisetron, droperidol and dexamethasone on postoperative nausea and vomiting （PONV） after laparoscopic cholecystectomy （LC）. Methods One hundred and sixty ASA Ⅰ or Ⅱ patients scheduled for LC were randomly divided into four groups with 40 cases each. The patients in group A received a single pre-anaesthesia intravenous does of dexamethasone 10 mg, and in group B droperidol 2. 5 mg, in group C droperidol 2.5 mg plus dexamethasone 10 mg, and in group D granisetron 3 mg. Observed the incidence of PONV in the 24 h. Results The PONV incidences of group A,B,C,D are 78%, 63%, 25% and 28%. Both group C and group D significantly decreased the total incidences of PONV（P〈0.01） in the 24 h. But there was no marked difference between group C and D. Conclusion Dexamethasone or droperidol alone did not significantly reduce the incidence of PONV after LC. Granisetron is obvious effective for this purpose and also combination of droperidol and dexamethasone. But the value-capability ratio of droperidol plus dexamethasone is better than granisetron.

关 键 词：术后恶心呕吐 腹腔镜胆囊切除术 格拉司琼 氟哌利多 地塞米松 

分 类 号：R614[医药卫生—麻醉学]