围麻醉期不同类型的液体治疗对胆囊切除术后恶心呕吐的影响  

The Effect of Colloid on the Postoperative Nausea and Vomiting in Fluid Therapy During Anesthesia

作　　者：林斌[1] 李平[1] 

机构地区：[1]四川省岳池县人民医院麻醉科,638300

出　　处：《医学理论与实践》2013年第1期5-7,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探讨围麻醉期不同类型的液体治疗对胆囊切除术后恶心呕吐的影响。方法:64例ASAⅠ～Ⅱ级行择期开腹胆囊切除术的患者随机分为羟乙基淀粉液组(H组)和乳酸林格氏液组(L组),根据患者的体重计算出患者的补液量。比较两组患者麻醉时间、苏醒时间、丙泊酚及瑞芬太尼的用量,两组患者术中总输液量、总出血量、输血量及平均尿量,两组患者术前、术后凝血功能以及两组患者术后30min、1h、4h、8h、24h的恶心呕吐的发生程度。结果:H组患者术后30min、1h、4h、8h、24h的恶心呕吐的发生程度明显低于L组患者,其差异具有统计学意义(P<0.05)。两组患者术中总输液量、总出血量及平均尿量比较无明显差异。H组患者术后PT、APTT均明显长于术前,且明显长于L组患者术后PT及APTT的时间,且差异具有统计学意义(P<0.05),但H组术后PT及APTT均在正常范围之内。结论:围麻醉期合理应用胶体液,能明显降低术后恶心、呕吐的发生几率,减少由此而产生的副作用。Objective：To discuss the effect of colloid on the postoperative nausea and vomiting in fluid therapy during anesthesia.Methods：64 ASA classⅠor Ⅱpatients who undergoing elective open cholecystectomy were randomly divided into hetastarch group（group H） and lactated Ringer＇s solution group（group L）.The patients of group H received the hetastarch and sodium chloride,the group L received lactated Ringer＇s solution on the basis of a fluid administration algorithm.Comparing the difference of patients with anesthesia duration,awakening time,the consumption of remifentanil and propfol,the MAP,HR during the anesthesia,at the same time,comparing the difference of degree of postoperative nausea and vomiting and the time of hemorrhage and coagulation during anesthesia.Results：There was no significant difference in anesthesia duration,awakening time,remifentanil consumption,MAP and HR during anesthesia.The VAS of postoperative nausea and vomiting in group H was obviously lower than it in group L（P0.05）.But the time of hemorrhage and coagulation in group H was obviously longer than group L.Conclusion：The reasonable application of the colloid fluid during anesthesia can obviously reduce the risk of postoperative nausea and vomiting.

关 键 词：液体治疗 胆囊切除术 术后恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]