昂丹司琼、甲氧氯普安和氟哌利多预防神经外科手术后患者恶心呕吐的临床对照研究

Clinical control study of ondansetron, metoclopramide and haloperidol in the prevention of postoperative nausea and vomiting after neurosurgery

目的探讨昂丹司琼、甲氧氯普安和氟哌利多预防神经外科手术后患者恶心呕吐的临床差异。方法共纳入90例神经外科手术治疗患者，采用随机数字表法分为四组，麻醉诱导后对照组18例给予0.9％氯化钠10ml；昂丹司琼组24例给予昂丹司琼4mg；甲氧氯普胺组24例给予甲氧氯普胺10mg；氟哌利多组24例给予氟哌利多2．5mg。比较各组疗效及不良反应。结果与对照组比较，昂丹司琼组、甲氧氯普胺组和氟哌利多组均能明显地抑制神经外科手术后恶心呕吐的发生，差异有统计学意义（P〈0．05）；昂丹司琼组总有效率[79．2％（19／24）]明显高于甲氧氯普胺组[58．3％（14／24）]及氟哌利多组[54．2％（13／24）]，差异有统计学意义（P〈0．05）；而甲氧氯普胺组与氟哌利多组总有效率比较差异无统计学意义（P〉0．05）。甲氧氯普胺组不良反应发生率[16．7％（4／24）]与昂丹司琼组[8．3％（2／24）]、氟哌利多组[12．5％（3／24）]比较差异无统计学意义（P〉0．05）。结论昂丹司琼、甲氧氯普胺和氟哌利多均能明显地抑制神经外科手术后恶心呕吐的发生，且昂丹司琼作用明显好于甲氧氯普胺及氟哌利多。因此对神经外科手术患者术中使用抗恶心呕吐药物是必要的。

Objective To investigate the clinical difference of ondansetron,metoclopramide and haloperidol in the prevention of postoperative nausea and vomiting after neurosurgery. Methods Ninety patients with ncurosurgery were divided by random digits table method into four groups： control group （18 cases） treated with 10 ml 0.9% sodium chloride;ondansetron group （24 cases） received ondansetron 4 mg; metoclopramide group （24 cases） with metoclopramide 10 mg and haloperidol group （24 cases） with haloperidol 2.5 mg. The efficacy and adverse reaction were compared among four groups. Results Compared with control group,ondansetron,metoclopramide and haloperidol could obviously inhibit the occurrence of postoperative nausea and vomiting after neurosurgery, the difference had statistical significance （P 〈 0.05 ）. Total effective rate of ondansetron group [ 79.2% （19/24）] was significantly higher than that of metoclopramide group [ 58.3% （14/24） ] and haloperidol group [ 54.2% （13/24） ] （P 〈 0.05）. And total effective rate of metoclopramide group and haloperidol group had no significant difference （P 〉 0.05 ）. The occurrence rate of adverse reaction of metoclopramide group [ 16.7% （4/24）] had no statistical significance compared with that of ondansetron group [ 8.3 % （ 2/24 ） ] and haloperidol group [ 12.5% （ 3/24 ） ] （P 〉 0.05 ）. Conclusions Ondansetron, metoclopramide and haloperidol can obviously inhibit the occurrence of postoperative nausea and vomiting after neurosurgery, and the effect of ondansetron is significantly better than that of metoelopramide and haloperidol. Therefore,it is necessary to use drugs for preventing postoperative nausea and vomiting for patients during neurosurgery.