联合应用止吐药预防全麻术后恶心呕吐的临床观察  

Clinical Obseration on Combination Use of Antiemetic Druge to Prevent Nausea and Vommiting after General Anesthesia

作　　者：张莉莉[1] 李俊[1] 张寒莉[1] 

机构地区：[1]大庆油田总医院麻醉科,黑龙江大庆163001

出　　处：《中国伤残医学》2011年第6期15-17,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:本文旨在腹腔镜胆囊手术中,应用不同组合止吐药物,测定血清5-羟色胺(5-HT)浓度的变化,观察术后24小时患者恶心呕吐情况,以此探讨3种止吐药物联合应用对高呕吐风险女性患者行腹腔镜胆囊切除手术后血清5-羟色胺和术后恶心呕吐的影响。方法:选择择期腹腔镜胆囊切除术(LC)女性患者60名,每组20例。Ⅰ组给予恩丹西酮,Ⅱ组给予恩丹西酮+地塞米松,Ⅲ组给予恩丹西酮+地塞米松+氟哌利多。监测4个时间点5-HT的浓度。结果:术后恶心呕吐情况Ⅲ组与Ⅰ,Ⅱ组比较差异有显著性(P<0.05)。Ⅲ组T3低于Ⅰ、Ⅱ组,差异有显著性(P<0.05),组内比较,Ⅰ、Ⅲ组T1与T0比较P<0.05。结论:3种止吐药物联合预防应用于高呕吐风险患者的腹腔镜胆囊切除手术术后恶心呕吐,临床效果明显。不良反应最轻,较单药应用效果更好。Objective： To apply different combinations of antiemetic drugs to determine concentration changes of serum 5-HT of patients undergoing laparoscopic gallbladder surgery and to observe nausea and vomiting state after 24 hours and to explore how the combined application of three kinds of antiemetic drugs would influence high vomiting risk female patients after laparoscopic cholecystectomy in serum 5-HT and post-operative nausea and vomiting, Methods：To operate laparoscopic cholecystectomy （LC）on 60 female patients, divided into three groups of 20 each. Patients of the first group were given ondansetron; those of the second were given ondansetron with dexamethasone; Ondansetron with dexamethasone and droperidol were given to those of the third group. Taken 5ml radial vein respectively at 4 time points.Results： For postoperative nausea and vomiting, the third group was obviously different from the first and second one （P〈0.05）; while at T1, T2 and T3, 5-HT concentrations of the third group was lower than the other two groups and differences were significant （P〈0.05）. Conclusion： The clinical effect was positive when applying three kinds of antiemetic drugs in combination to prevent high risk vomiting patients from postoperative nausea and vomiting in laparoscopic cholecystectomy. They greatly reduced the incidence of PONV with the lightest adverse reactions after abdominal surgery. They might be much better than the single drag application.

关 键 词：术后恶心呕吐 止吐药 腹腔镜胆囊切除手术 血清5-HT 

分 类 号：R917[医药卫生—药物分析学]