帕洛诺司琼与托烷司琼预防老年患者腹腔镜宫颈癌根治术后恶心呕吐的效果比较  

Comparison of palonosetron and tropisetron in preventing postoperative nausea and vomiting after laparoscopic cervical cancer radical resection in elderly patients

作　　者：张瑶[1] 姚献强[1] 朱运河[1] 沈洁[1] 夏凡[1] 候莉丽 

机构地区：[1]南京医科大学附属南京妇幼保健院麻醉科,江苏省南京市210004

出　　处：《实用老年医学》2016年第4期302-304,共3页Practical Geriatrics

摘　　要：目的比较帕洛诺司琼与托烷司琼预防老年患者腹腔镜宫颈癌根治术后恶心呕吐（PONV）的效果。方法择期腹腔镜下行子宫颈癌根治术老年患者90例（年龄≥60岁）,随机分为3组,每组30例,分别为对照组（Ⅰ组）、帕洛诺司琼组（Ⅱ组）和托烷司琼组（Ⅲ组）。麻醉诱导前,Ⅰ组未注射止吐剂,Ⅱ组和Ⅲ组分别注射帕洛诺司琼0.25 mg或托烷司琼5 mg。记录术前、术中2 h、手术结束时的平均动脉压（MAP）、心率（HR）,记录术后0~3 h、3~24 h,24~48 h恶心呕吐的发生率及完全缓解率（CRR）。结果术中患者血流动力学波动在正常范围内。与Ⅰ组相比,Ⅱ组与Ⅲ组术后0~3 h、3~24 h,24~48 h内恶心呕吐的发生率均有降低,CRR均升高（P〈0.05）。在24~48 h时间段Ⅱ组的恶心呕吐发生率比Ⅲ组更低,CRR更高（P〈0.05）。结论帕洛诺司琼对于减少老年患者腹腔镜宫颈癌根治术后24~48 h的恶心呕吐发生率更具有优势,老年高危PONV患者可优先选择帕洛诺司琼。Objective To compare the efficacy of palonosetron and tropisetron in preventing postoperative nausea and vomiting（ PONV） in the elderly patients undergoing laparoscopic cervical cancer radical resection. Methods Ninety elderly patients who received laparoscopic cervical cancer radical resection,were randomly divided into three groups：control group（ group Ⅰ,not receiving any antiemtic）,palonosetron group（ group Ⅱ,receiving 0. 25 mg palonosetron）and tropisetron group（ group Ⅲ,receiving 5 mg tropisetron）. The levels of mean arterial pressure（ MAP） and heart rate（ HR） were recorded before the operation,at 2 h and the end of the operation. The incidence of PONV and the complete response rate（ CRR） were recorded postoperatively during 0-3 h,3-24 h or 24-48 h. Results The haemodynamics in the patients were within normal range during operation. Compared with the control group,the incidence of nausea and vomiting in group Ⅱ and group Ⅲ was decreased 0-3 h,3-24 h or 24-48 h after operation,and the level of CRR was increased（ P0. 05）. 24-48 h after operation,the incidence of nausea and vomiting in group Ⅱ was lower and CRR was higher than that in group Ⅲ（ P 0. 05）. Conclusions Compared with the tropisetron,palonosetron could effectively reduce the incidence of nausea and vomiting 24-48 h after operation. As a result,palonosetron may be the preferred choice for the elderly patients with high risk of PONV.

关 键 词：术后恶心呕吐 帕洛诺司琼 托烷司琼 腹腔镜 老年人 

分 类 号：R713.4[医药卫生—妇产科学]