昂丹司琼联合地塞米松预防妇科腹腔镜术后恶心呕吐的疗效观察

Clinical observation of Ondansetron combined with dexamethasone in preventing postoperative nausea and vomiting for gynecologic laparoscopic surgery

目的评价昂丹司琼联合地塞米松预防妇科腹腔镜术后恶心呕吐的临床疗效。方法选择90例ASAⅠ～Ⅱ级行妇科腹腔镜手术的病人,随机将病人分为三组,在手术结束时分别静注昂丹司琼8mg和地塞米松10mg(A组,n=30),昂丹司琼8mg(B组,n=30)、生理盐水(对照组,C组,n=30)。结果在术后8小时内和9￣24小时内恶心呕吐发生率A组(16.7%、10.0%)和B组(20.0%、33.3%)明显低于C组(63.3%、60.0%)(P<0.05),A组在术后8小时内恶心呕吐发生率与B组比较无显著性差异(P>0.05),但在术后9￣24小时内恶心呕吐发生率明显低于B组(10.0%vs33.3%)(P<0.05)。结论昂丹司琼联合地塞米松可显著减少妇科腹腔术后恶心呕吐发生率,而且其作用维持时间要长于单纯应用昂丹司琼。

Objective To evaluate the prnphylaetic effect of ondansetron eonthined with dexarnethasone on postoperative nausea and vomiting （PONV） for gynecologic laparoseopie surgery. Methods 90 patients of ASA Ⅰ -Ⅱ undergone laparoscopie gynecologic operation were randomly divided into three groups,at the end of the operation which received respectively an intravenous bolus of ondansetron 8 mg and dexamethasonc 10 mg （groupA,n=30）,ondansetron 8 mg（grougB,n=30）,0.9% NS 3 ml（group placebo,groupC,n=30）. Results The incidences of PONV in group A（16.7%, 10.0%）and group B（20.0%,33.3%）were significantly lower than those of group C（63.3%,60.0%）（P〈0.05） in postoperative 8 hours and 9 - 24 hours.The incidence of PONV in group A was similar to that in group B in postoperative 8 hours （P〈0.05）,but significantly lower than that in group B in postoperative 9 - 24 hours （10.0%,vs 33.3%）（P〈0.05）.Conclusion Ondansetron combined with dexamethasone may significantly prevent PONV of gynecologic laparoscopie surgery, and the declination of effect was longer than that of ondansetron only.