盐酸帕洛诺司琼对下腹部手术后恶心呕吐的预防作用  

Preventive Effect of Palonosetron Hydrochloride on Nausea and Vomiting after Abdominal Operation

作　　者：许培阳[1] 吴志云[1] 

机构地区：[1]中国人民解放军第180医院麻醉科,福建泉州362000

出　　处：《南昌大学学报（医学版）》2013年第4期57-59,63,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的观察和评价盐酸帕洛诺司琼对下腹部手术后恶心、呕吐的预防效果和安全性。方法选择择期行下腹部手术并术后接受静脉镇痛患者50例,按随机数字表法分为帕洛诺司琼组(P组)和托烷司琼组(T组),每组25例。手术结束前30min,P组患者缓慢静脉注射盐酸帕洛诺司琼0.25mg,T组患者缓慢静脉注射托烷司琼5mg。观察记录2组患者术后24、48h的视觉模拟评分法(VAS)评分及恶心、呕吐的程度,计算恶心、呕吐有效控制率。同时记录患者腹胀、头痛等不良反应。结果 2组术后24h及48h的VAS评分差异无统计学意义(均P>0.05)。P组术后24h的恶心及呕吐有效控制率分别为84.0%和88.0%,T组分别为76.0%和80.0%,2组比较差异无统计学意义(均P>0.05);P组患者术后48h的恶心及呕吐有效控制率均为92.0%,T组分别为64.0%和60.0%P组恶心、呕吐有效控制率明显优于T组(P<0.05)。P组有2例(8%)轻微头痛,T组有1例(4%)轻微头痛,2组不良反应率比较差异无统计学意义(P>0.05)。结论帕洛诺司琼预防下腹部手术后静脉镇痛所致的恶心、呕吐的效果,24h内与托烷司琼相当,但术后48h预防恶心呕吐的效果明显优于托烷司琼,且安全性好。Objective To observe and evaluate the efficacy and safety of palonosetron hydrochloride in the prevention of nausea and vomiting after abdominal operation.Methods Fifty patients receiving intravenous analgesia for abdominal surgery were randomly assigned to receive slow intravenous injection with either 0.25mg palonosetron hydrochloride（group P,n=25） or 5mg tropisetron（group T,n=25） 30minutes before the end of operation.Visual analogue scale（VAS） scores,degree of nausea and vomiting and incidence of adverse reactions（abdominal distention,headache,etc.） were recorded.The effective control rates of nausea and vomiting were calculated.Results There were no significant differences in VAS score between the two groups 24and 48hours after operation（P＆gt;0.05）.The effective control rates of nausea and vomiting were,respectively,84.0%and 88.0%in group P,and 76.0%and 80.0%in group T 24hours after operation.No significant differences were found between the two groups（P＆gt;0.05）.Compared with group T,the effective control rates of nausea and vomiting significantly increased in group P 48hours after operation（92.0% vs 64.0% and 92.0% vs 60.0%,respectively;P＆lt; 0.05）.Mild headache occurred in 2patients（8%） in group P and in 1patient（4%） in group T.The difference in the incidence of adverse reactions was not significant between the two groups （P＆gt;0.05）.Conclusion The preventive effect of palonosetron hydrochloride on nausea and vomiting induced by intravenous analgesia is equal to that of tropisetron within 24hours after operation.However,palonosetron hydrochloride is superior to tropisetron for preventing nausea and vomiting 48hours after operation.

关 键 词：帕洛诺司琼 恶心 呕吐 手术 下腹部 静脉镇痛 

分 类 号：R614.24[医药卫生—麻醉学] R619.9[医药卫生—外科学]