帕洛诺司琼联合膈神经阻滞对甲状腺术后恶心呕吐的疗效分析  

Effect of Palonosetron Combined with Phrenic Nerve Block on Postopera⁃tive Nausea and Vomiting of Thyroid Tumor

作　　者：赵元哲 王冰 周琪[1] 王东阳 周伏园 ZHAO Yuanzhe;WANG Bing;ZHOU Qi;WANG Dongyang;ZHOU Fuyuan(Department of Pain,Chifeng Hospital,Chifeng,Inner Mongolia Autonomous Region,024000 China;Department of Reproductive Medicine,Affiliated Hospital of Chifeng University,Chifeng,Inner Mongolia Autonomous Region,024000 China;Tongliao Center for Disease Control and Prevention,Tongliao,Inner Mongolia Autonomous Region,028000 China)

机构地区：[1]赤峰市医院疼痛科,内蒙古赤峰024000 [2]赤峰学院附属医院生殖医学科,内蒙古赤峰024000 [3]通辽市疾病预防控制中心,内蒙古通辽028000

出　　处：《系统医学》2023年第11期73-77,共5页Systems Medicine

摘　　要：目的 探讨帕洛诺司琼联合膈神经阻滞对甲状腺肿瘤术后恶心呕吐(postoperative nausea and vomiting,PONV)的疗效。方法 选择2018年6月-2020年6月赤峰市医院收治的甲状腺肿瘤患者60例为研究对象,采用随机数表法分为两组,每组30例。帕洛诺司琼组(P组)麻醉前静注帕洛诺司琼0.25 mg;帕洛诺司琼+膈神经阻滞组(P+G组)术前行膈神经阻滞且麻醉前静注帕洛诺司琼0.25 mg。比较两组患者术后0~6 h、6~24 h视觉模拟评分法(Visual Analogue Scale, VAS)评分,术后0~6 h、6~24 h、24~48 h、48~72 h恶心、呕吐发生情况。结果 术后0~6 h、6~24 h,P+G组患者VAS评分分别为(2.49±0.88)分、(1.20±0.49)分,明显低于P组(3.20±1.04)分、(2.17±0.61)分,差异有统计学意义(t=2.902、6.902,P<0.05)。P+G组患者术后0~6 h、6~24 h、24~48 h、48~72 h的PONV发生率分别为10.0%、6.7%、3.3%、0,低于P组的40.0%、33.3%、26.7%、20.0%,差异有统计学意义(χ^(2)=7.200、6.667、4.706、4.630,P<0.05)。结论 帕洛诺司琼联合膈神经阻滞较单用帕洛诺司琼预防甲状腺肿瘤术后高危患者PONV的效果更理想。Objective To investigate the effect of palonosetron combined with phrenic nerve block on postoperative nausea and vomiting(PONV)of thyroid tumors.Methods 60 patients with thyroid tumor treated in Chifeng Hospital from June 2018 to June 2020 were selected as the study objects,and were divided into two groups by random number table method,with 30 patients in each group.Palonosetron group(Group P)was given palonosetron 0.25 mg before an⁃esthesia.Palonosetron+phrenic nerve block group(P+G group)received phrenic nerve block before surgery and Palo⁃nosetron 0.25 mg before anesthesia.The Visual Analogue Scale(VAS)score and the incidence of nausea and vomiting 0-6 h,6-24 h,24-48 h,and 48-72 h after surgery were compared between the two groups.Results The VAS scores in the P+G group were(2.49±0.88)points and(1.20±0.49)points,respectively,0-6 h and 6-24 h after surgery,which were significantly lower than those in the P group(3.20±1.04)points and(2.17±0.61)points,and the difference was statistically significant(t=2.902,6.902,P<0.05).The PONV incidence rates in P+G group were 10.0%,6.7%,3.3%and 0 at 0 to 6 h,6 to 24 h,24 to 48 h and 48 to 72 h,respectively,which were lower than those in P group(40.0%,33.3%,26.7%and 20.0%),and the difference was statistically significant(χ2=7.200,6.667,4.706,4.630,P<0.05).Conclusion Palonosetron combined with phrenic nerve block is more effective than Palonosetron alone in preventing PONV in high-risk patients after thyroid tumor surgery.

关 键 词：术后恶心呕吐 帕洛诺司琼 膈神经阻滞 甲状腺 

分 类 号：R61[医药卫生—外科学]