内关穴注射小剂量恩氟合剂超前镇吐用于腹腔镜胆囊切除临床效果观察  

Clinical observation on the therapeutic effect of Neiguan point injection with low-dose misture of ondansetron and droperidol on preemptive antivomit in laparoscopic cholecystectomy

作　　者：朱红霞[1] 徐艳洁[2] 孟素峰 冯琥[1] 刘苑[1] 苏心镜[1] 

机构地区：[1]河北北方学院附属第二医院,河北省张家口市075100 [2]河北北方学院附属第一医院 [3]宣化钢铁公司职工医院

出　　处：《河北医药》2010年第5期533-534,共2页Hebei Medical Journal

基　　金：张家口市科学技术研究与发展指导计划项目(编号:0921113D)

摘　　要：目的观察内关穴注射小剂量恩氟合剂超前镇吐用于腹腔镜胆囊切除的临床效果。方法选择ASAⅠ～Ⅱ级拟行腹腔镜下胆囊切除术患者150例,采用随机数字表将患者随机分为3组,每组50例。Ⅰ组患者于术前20 min行恩氟合剂(恩丹西酮4 mg,氟哌利多2.5 mg,共3 ml)双侧内关穴注射;Ⅱ组患者于术前20 min静脉注射恩氟合剂3 ml;Ⅲ组患者术前20 min静脉注射0.9%氯化钠液3 ml。观察各组患者术后24 h恶心呕吐的发生次数与程度,并按评定标准予以评分。结果恶心发生率:Ⅰ组10%,Ⅱ组52%,与Ⅲ组(80%)比较差异有统计学意义(P<0.01),Ⅰ组与Ⅱ组比较差异有统计学意义(P<0.01)。呕吐发生率:Ⅰ组6%,Ⅱ组44%,与Ⅲ组(72%)比较差异有统计学意义(P<0.01);Ⅰ组与Ⅱ组比较差异有统计学意义(P<0.01)。3组患者均未发现明显嗜睡、焦虑及锥体外系反应等并发症。结论内关穴注射小剂量恩氟合剂超前镇吐用于腹腔镜胆囊切除术,能阻断引起PONV的多个因素,临床效果确切,可减少或避免大剂量单一用药所导致的诸多并发症。Objective To observe the clinical effect of Neiguan point injection with low-dose misture of ondansetron and droperidol on preemptive antivomit in laparoscopic cholecystectomy.Methods 150 ASAⅠ~Ⅱ patients who were performed by laparoscopic cholecystectomy were randomly divided into 3 groups（50 cases in each group）.The patients in group Ⅰtook an injection on bothsides of Neiguan point with the misture of ondansetron and droperidol（ondansetron 4mg and droperidol 2.5mg,together 3ml） 20 min before operation;the patients in group Ⅱtook a vein shot of 3ml misture of ondansetron and droperidol,while the ones in group Ⅲ took 0.9% sodium chloride solution 3ml,20min before operation.The frequency and degree of nausea and vomiting 24 hours after operation in each group were observed and scored according to certain standard.Results The incidence of nausea was 10% in groupⅠ,while 52% in group Ⅱ,which was 82% in group Ⅲ,and there was a significant difference between the former 2 groups and group Ⅲ（P 0.01）,and between groupⅠand groupⅡ（P 0.01）.The incidence of vomiting was 6% in group Ⅰ,while 44% in group Ⅱ,which was 72% in group Ⅲ,and and there was a significant difference between the former 2 groups and group Ⅲ（P 0.01）,and between groupⅠand groupⅡ（P 0.01）.No complications such as obvious drowsiness,anxiety and extracorticospinal tract reaction were found among the three groups.Conclusion Neiguan point injection with low-dose misture of ondansetron and droperidol for preemptive antivomit in laparoscopic cholecystectomy can certainly block many factors causing PONV,which can reduce or avoid many complications caused by high-dose single medication.

关 键 词：超前镇吐 恩丹西酮 氟哌利多 穴位注射 腹腔镜 胆囊切除术 恶心呕吐 

分 类 号：R657.4[医药卫生—外科学]