昂丹司琼静注联合超声针灸内关穴对腹腔镜全子宫切除术患者术后恶心呕吐及血浆胃泌素浓度的影响  

Effect of Ondansetron Combined with Ultrasonic Acupuncture at Neiguan Point on Postoperative Nausea and Vomiting and Plasma Gastrin Concentration in Patients Undergoing Laparoscopic Hysterectomy

作　　者：华静[1] 彭永保[1] 孙杨 周群[1] HUA Jing;PENG Yongbao;SUN Yang;ZHOU Qun(Jiangxi Maternal and Child Health Hospital,Nanchang Jiangxi 330006,China)

机构地区：[1]江西省妇幼保健院,江西南昌330006

出　　处：《药品评价》2022年第24期1497-1500,共4页Drug Evaluation

基　　金：江西省中医药管理局科技计划(2020B0285)。

摘　　要：目的:研究昂丹司琼联合超声针灸内关穴对腹腔镜全子宫切除手术患者术后恶心呕吐及血浆胃泌素(GAS)浓度的影响。方法:选择2022年1至3月在江西省妇幼保健院收治的80例拟行腹腔镜全子宫切除手术患者,将其随机分为研究组(n=40,全身麻醉诱导前半小时于右侧内关穴行超声针灸,全身麻醉结束前半小时静脉注射昂丹司琼4 mg),对照组(n=40,仅在全身麻醉结束前半小时静脉注射生理盐水4 mL)。两组均采用全凭静脉麻醉,术后都配置同样药品剂量的静脉镇痛泵(舒芬太尼+酮咯酸氨丁三醇+生理盐水)进行术后镇痛。在未行针灸麻醉前半小时(T1)、手术结束即刻(T2)、术后12 h(T3)、术后24 h(T4)采用ELISA法测定血浆胃泌素(GAS)浓度,同时记录两组患者术后2 h、2~6 h、6~12 h和12~24 h发生恶心呕吐的情况。结果:与同组的T1时刻比较,两组患者T2、T3、T4时刻的血浆GAS水平均增加(P<0.05);在相同时刻,与对照组相比,研究组T2、T3时刻血浆GAS浓度更低(P<0.05),其余时刻两组GAS水平差异无统计学意义(P>0.05);研究组术后2 h内及2~6 h发生恶心呕吐率更低(P<0.05),其余时刻差异无统计学意义(P>0.05)。结论:静脉注射昂丹司琼联合超声针灸内关穴可显著减少腹腔镜全子宫切除手术患者术后恶心呕吐发生率,减少GAS过度释放。Objective:Study the effect of ondansetron combined with ultrasonic acupuncture at neiguan point on postoperative nausea and vomiting(PONV)and plasma gastrin(GAS)concentration in patients undergoing laparoscopic hysterectomy.Methods:A total of 80 patients who planned to undergo laparoscopic hysterectomy in Jiangxi Maternal and Child Health Hospital from January to March 2022 were selected,and randomly divided into the study group(n=40,ultrasonic acupuncture at right neiguan point half an hour before induction of general anesthesia,intravenous ondansetron 4 mg half an hour before the end of general anesthesia)and the control group(n=40,intravenous physiological saline 4 mL half an hour before the end of general anesthesia).Both groups were treated with total intravenous anesthesia,and the same dosage of provided with intravenous analgesic pump(sufentanil+ketorolac tromethamine+physiological saline).The plasma GAS concentration were measured by ELISA at half an hour before acupuncture anesthesia(T1),immediately after surgery(T2),12 hours after surgery(T3)and 24 hours after surgery(T4).The incidences of PONV within 2 h,2-6 h,6-12 h and 12-24 h after surgery were recorded respectively.Results:Compared with the T1 moment of the same group,the plasma GAS concentration at the T2,T3,and T4 moments in both the two groups were increased(P<0.05).At the same time,compared with the control group,the plasma GAS concentration were lower in the study group at T2 and T3(P<0.05),and there was not statistically significant between the two groups at the rest of the time(P>0.05).The incidences of PONV within 2 h,and 2-6 h after surgery in the study group were lower than those in the control group(P<0.05),and the rest of the time was not statistically significant(P>0.05).Conclusion:Intravenous ondansetron combined with ultrasonic acupuncture at neiguan point can significantly reduce the incidence of PONV in patients undergoing laparoscopic hysterectomy,reduce excessive GAS release.

关 键 词：手术后恶心呕吐 子宫切除术 腹腔镜检查 胃泌素类 昂丹司琼 

分 类 号：R614[医药卫生—麻醉学]