术前水化对腹腔镜下胆囊切除术患者术后恶心呕吐的影响  

Effect of preoperative hydration on postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy

作　　者：刘明明 何姗[1] 李国建[1] LIU Ming-ming;HE Shan;LI Guo-jian(Anesthesiology Department,New Rongqi Hospital,Foshan,China)

机构地区：[1]广东省佛山市顺德容桂街道新容奇医院麻醉科

出　　处：《广东医科大学学报》2020年第1期87-90,共4页Journal of Guangdong Medical University

摘　　要：目的探讨术前水化对腹腔镜下胆囊切除术(LC)患者术后恶心呕吐(PONV)的影响。方法98例行LC患者随机分为对照组和观察组,每组49例。对照组患者术前1 h输注2 mL/kg林格氏液作为基础补液,观察组患者术前1 h输注15 mL/kg林格氏液进行充分水化。记录两组患者围手术期麻醉时间、手术时间、总补液量和芬太尼用量。通过视觉模拟评分法(VAS)记录两组患者术后1、2、6、12、24 h内不同时间段疼痛程度和恶心程度。记录两组患者术后24 h内呕吐发生率以及止呕药物昂丹司琼和甲氧氯普胺的使用情况。结果观察组总补液量高于对照组;术中芬太尼用量低于对照组;术后1、2、6、12、24 h疼痛VAS评分及恶心VAS评分均低于对照组;术后24 h内呕吐总发生率低于对照组;术后24 h昂丹司琼和甲氧氯普胺使用率均低于对照组(均P<0.05)。结论术前水化可显著降低LC患者PONV的发生和术后疼痛程度,减少LC患者术中阿片类药物和术后止呕药物的使用,值得在临床上推广。Objective To explore the effect of preoperative hydration on postoperative nausea and vomiting(PONV)in patients undergoing laparoscopic cholecystectomy(LC).Methods A total of 98 patients undergoing LC were divided into the Control Group and the Experimental Group(n=49)randomly.Patients in the Control Group were infused with 2 mL/kg Ringer's solution as basic fluid infusion and patients in the Experimental Group were infused with 15 mL/kg Ringer's solution 1h before operation for full hydration.Anesthesia time,operation time,total liquid supplement and fentanyl dosage of both groups were recorded during perioperative period.The degrees of pain and nausea in both groups were recorded with visual analogue scale(VAS)at 1,2,6,12,24h postoperatively.The incidence of vomiting and medication with ondansetron and metoclopramide in both groups were also recorded in 24 h postoperatively.Results The total amount of liquid supplement in the Experimental Group was higher than that in the Control Group.The Experimental Group had the usage of fentanyl lower than the Control Group,had the pain VAS and nausea VAS scores lower than the Control Group at 1,2,6,12,24 h postoperatively,had the total incidence of vomiting within 24 h after the operation lower than the Control Group and had the usage of ondansetron and metoclopramide at 24 h after the operation lower than the Control Group,and the differences were statistically different(P<0.05).Conclusion Preoperative hydration could significantly decrease the occurrence of PONV and the degree of postoperative pain,and reduce the use of opioids and postoperative antiemetic drugs.It is worth clinical promotion.

关 键 词：术前水化 腹腔镜下胆囊切除术 术后恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]