甲泼尼龙复合托烷司琼对术后恶心呕吐高危的甲状腺手术患者的预防作用  

Prophylactic Effect of Methylprednisolone Combined with Tropisetron on Patients at High Risk for Postoperative Nausea and Vomiting after Thyroid Surgery

作　　者：李运[1] 赵楠[1] 方波[1] 

机构地区：[1]中国医科大学附属第一医院麻醉科,辽宁沈阳110001

出　　处：《医学临床研究》2016年第10期1896-1898,共3页Journal of Clinical Research

基　　金：辽宁省博士科研启动基金（20141035）;辽宁省自然基金（2014021035）

摘　　要：[目的]探索甲泼尼龙复合托烷司琼对术后恶心呕吐（PONV）高危的甲状腺手术患者的预防作用。[方法]行甲状腺癌根治术的PONV高危患者120例，随机分为四组，每组30例。甲泼尼龙复合托烷司琼组（MT组）：手术结束前15min静注甲泼尼龙40mg＋托烷司琼5mg；甲泼尼龙组（M组）：手术结束前15min静注甲泼尼龙40mg；托烷司琼组（T组）：手术结束前15min静注托烷司琼5mg；对照组（C组）：手术结束前15min静注生理盐水。记录比较术后48h内恶心呕吐发生情况，使用视觉模拟评分法（VAS）评价PONV的严重程度。[结果]四组患者年龄、体重和手术时间相比较差异无显著性（P〉0．05）；与C组和T组比较，MT组拔管至术后2h（T0～2h）、术后2h至术后6h（T2h～6h）时段PONV发生率和T2h、T6h时VAs评分明显降低（P〈0．05）；与C组比较，MT组头痛发生率明显降低（P〈0．05），但眩晕、不安和高血糖发生率无明显变化（P〉0．05）。[结论]甲泼尼龙复合托烷司琼对PONV高危的甲状腺手术患者有显著的预防作用，且不良反应未见增加。[Objective]To explore the prophylactic effect of methylprednisolone combined with tropisetron on patients at high risk for postoperative nausea and vomiting （PONV） after thyroid surgery. [Method] A total 120 patients at high risk for postoperative nausea and vomiting scheduled for radical operation of thyroid carcinoma were randomly divided into four groups with 30 cases in each. At 15 min before end of the operations, patients in the four groups of the patients were intravenously injected methylprednisolone 40 mg plus tropisetron 5 mg （group MT）, methylprednisolone 40 mg （group M）, tropisetron 5 mg （group T）, and normal saline （group C）. Incidence and severity of nausea and vomiting were recorded within 48 hours after surgery, and the visual analogue scale （VAS） score was used to calculate the severity of PONV.[Results]There were no significant differences in age, body weight, or operation time amongst the four groups （ P 〉0.05）. Compared to groups C and T, the inci- dences of PONV during T0-2 h and T2 h-6 h and VAS score at T2 h and T6 h were significantly lower （ P 〈0.05）. Compared to group C, the incidence of headache in group MT was significantly lower （ P 〈0.05）, but the incidences of dizziness, anxiety, and hyperglycemia showed no obvious changes （ P 〈0.05）.[Conclusion]Methylprednisolone combined with tropisetron has significant preventative effect on patients at high risk for PONV and the adverse reactions do not increase.

关 键 词：甲泼尼龙/治疗应用 止吐药/治疗应用 手术后恶心呕吐/预防和控制 甲状腺肿瘤/外科学 

分 类 号：R736.1[医药卫生—肿瘤]