预防腹腔镜胆囊切除术后恶心呕吐的临床研究  

CLINICAL STUDY OF THE PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING AFTER LAPAROSECOPIC CHOLECYSTECTOMY

作　　者：黄绍农[1] 刘友坦[1] 魏世珍[1] 钟飞焱[1] 郑永辉[1] 王祖音[1] 赵迅[1] 

机构地区：[1]深圳市第二人民医院,深圳518035

出　　处：《肝胆外科杂志》2003年第4期287-288,共2页Journal of Hepatobiliary Surgery

摘　　要：目的　比较格拉司琼联合地塞米松及小剂量氟哌啶与单独应用格拉司琼对 L C术后 PONV的预防作用。方法　 86例 L C手术、女性病人 ,随机分为格拉司琼联合用药组、格拉司琼组及对照组 :观察术后 2 4 h内的恶心、呕吐发生率及副反应。结果　格拉司琼组及联合用药组术后 2 h内 PONV均显著低于对照组 (P<0 .0 5和 P<0 .0 1) ,联合用药组术后 2～ 12 hPONV显著低于对照组 (P<0 .0 1) ,术后 12～ 2 4 h PONV显著低于对照组 (P<0 .0 1)及格拉司琼组 (P<0 .0 5 )。结论　格拉司琼与地塞米松、氟哌啶联合用药预防 L C术后恶心呕吐的发生 ,疗效优于单用格拉司琼 ,没有明显的副作用 。Objective To compare the effects of Granisetron plus Dexamethasone and small dose Droperidol with Granisetron alone or placebo in the prevention of reducing post operative nausea and vomiting(PONV) after laparoscopic cholecystectomy.Methods Eighty six ASA Ⅰ Ⅱ female patients scheduled for laparoscopic cholecystectomy were randomly allocated to three groups:Group A(n=32):Dexamethasone 10 mg?Droperidol 1.25 mg were administered I.V. before anesthesia induction and Granisetron 3 mg was administered I.V.at the end of operation;GroupB(n=28):Normal Saline 5 ml was administered I.V.before anesthesia and Granisetron 3 mg was administered I.V. at the endof operation;Group C:Normal Saline 5 ml was administered I.V.before anesthesia and at the end of operation respectively.The occurrence of PONV was assessedduring 24 h after the operation.Result In the first 2h,the incidence of PONV in group A and group B were both significantly lowered than that in group C( p <0.01 and p <0.05 respectively);During the time from 2 12 h after operation,the incidence of PONV in group A was signifi cantly lowered than that in group C,but there is no significant difference of incidence between group B and group C( p >0.05);During the time from 12 24 h after operation,the incidence of PONV in group A was significantly lowered than those in group B and group C( p <0.05 and p <0.01 respectively).Conclusion Granisetron combined with Dexamethasone and a small dose of Droperidol is superior to Granisetron alone and placebo in preventing PONV undergoing laparoscopic cholecystectomy.

关 键 词：腹腔镜胆囊切除术 恶心呕吐 预防 手术后 

分 类 号：R657.4[医药卫生—外科学] R442.1[医药卫生—临床医学]