帕洛诺司琼在加速康复外科中的作用  

Role of palonosetron in enhanced recovery after surgery

作　　者：李坤河[1] 邬艳[1] 李毅[2] 肖亮灿[1] 

机构地区：[1]中山大学附属第一医院麻醉科,广州510080 [2]中山大学附属第一医院体外循环科,广州510080

出　　处：《中华普通外科学文献（电子版）》2016年第5期371-374,共4页Chinese Archives of General Surgery(Electronic Edition)

基　　金：广东省自然科学基金资助项目(S2012010010965)

摘　　要：目的探讨帕洛诺司琼在加速康复外科中的作用,为临床患者的围手术期康复提供更优质的服务。方法采用前瞻性、随机的研究方法,选择2015年9月至2016年2月拟行结直肠腹腔镜手术者120例,随机分为3组,各40例,各组术后行同配方的静脉镇痛。A组手术结束前1 h静推托烷司琼6 mg;B组手术结束前1 h静推帕洛诺司琼0.25 mg;C组手术结束前1 h静推帕洛诺司琼0.25 mg,静脉镇痛泵中静脉泵注帕洛诺司琼0.25 mg/72 h。记录并比较各组患者术后恶心、呕吐(PONV)等并发症发生率以及下床天数、出院时间。结果 B组和A组术后恶心、呕吐发生率差异无统计学意义,C组较之A组、B组在术后24 h后PONV发生率差异有统计学意义(x^2=5.165、5.165,P=0.023、0.023);C组、B组较之A组术后镇痛24 h内除PONV外其余并发症发生率差异无统计学意义,24 h后除PONV外其余并发症发生率差异有统计学意义(x^2=4.500、6.275,P=0.033、0.012);C组较之A组、B组术后下床天数(t=3.718、2.975,P<0.001、0.004)、出院时间(t=6.650、5.440,均P<0.001)差异有统计学意义。结论帕洛诺司琼持续用药效果更稳定,可降低术后恶心、呕吐发生率,加速患者术后康复。Objective To investigate the role of palonosetron in enhanced recovery after surgery（ERAS）, and to provide a better choice for perioperative clinical patients. Methods A prospective,randomized study was carried out, enrolling one hundred and twenty patients undergoing laparoscopiccolorectal surgery from September 2015 to February 2016, who were randomly divided into three groupswith 40 cases in each group. All patients were treated with postoperative intravenous analgesia（PCIA） in thesame formulation. Group A（control group） were given i. v 6 mg bolustropisetron 1 hour before the end of thesurgery; Group B i. v 0.25 mg boluspalonosetron; Group C i. v 0.25 mg bolus palonosetron, then addedintravenous palonosetron 0.25 mg/72 h. The incidence of postoperative nausea and vomiting（PONV）,complication in PCIA except PONV, ambulation after surgery, and hospital- stay days were recorded.Results The incidence of postoperative nausea and vomiting between Group B and Group A had nosignificant difference. Compared with Group A and Group B, the incidence of postoperative 24 h PONV inGroup C was significantly different（χ^2=5.165, 5.165, P=0.023, 0.023）. The incidence of complication inPCIA except PONV between Group C and Group B, and Group C and Group A had significant differencesafter 24 h（χ^2=4.500, 6.275, P=0.033, 0.012）. Ambulation after surgery and the discharging days aftersurgery in Group C had significant differences compared to Group A and B（t=3.718, 2.975, P〈0.001,0.004; t=6.650, 5.440, both P〈0.001）. Conclusion Palonosetron continued injecting can more effectivelyreduce the incidence of postoperative nausea and vomiting, and improve the quality of rehabilitation.

关 键 词：结直肠外科手术 康复 帕洛诺司琼 手术后恶心呕吐 镇痛 

分 类 号：R614[医药卫生—麻醉学]