盐酸戊乙奎醚联合托烷司琼预防术后恶心呕吐的临床研究

Clinical study on preventing postoperative nausea and vomiting with penehyclidine hydrochlorideand and tropisetron during the peroperative period

目的评价盐酸戊乙奎醚联合托烷司琼对术后恶心呕吐（PONV）的防治效果。方法将120例ASAⅠ-Ⅱ级、年龄32-38岁、计划在全身麻醉下进行腹腹腔镜手术的患者随机旁力生理盐水对照组、托烷司琼组及盐酸戊乙奎醚联合托烷司琼组三组，每组40例。记录术后6h（T1）、12h（T2）、24h（T3）和48h（T4）的视觉模拟评分（VSS）情况，并对各个时段出现呕吐症状的病例计数。结果T1～T3时托烷司琼组术后恶心呕吐的VSS评分明显低于对照组（P〈0．05），而T4时差异无统计学意义；T1～T4时盐酸戊乙奎醚联合托烷司琼组术后恶心呕吐的VSS评分明显低于对照组和托烷司琼组（P〈0．05）；三组均有呕吐发生，但盐酸戊乙奎醚联合托烷司琼组呕吐发生率明显低于托烷司琼组及生理盐水对照组（P〈0．05）。结论与单独应用托烷司琼相比，盐酸戊乙奎醚联合托烷司琼组能更大程度地减少PONV。

Objective To evaluate the preventive and treatment effect of penehyclidine hydro-chloride and tropisetron on postoperative nausea and vomitting during the peroperative period. Methods One hundred and twenty ASA class Ⅰ - Ⅱ patients scheduled for laparoscopic surgery undergoing gener-al anesthesia were randomly divided into three group：patients in group Ⅲ were injected with penehyclid-ine hydrochloric at the dosage of 0. 01 mg/kg before anesthesia induction and given tropisetron 5 mg at end of surgery;patients in group Ⅱ were injected with tropisetron 5 mg at end of surgery and patients in group I were given 0. 9% sodium chloride （ group Ⅰ ）. Visual simulation scale （VSS） were used to as-sess PONV and VSS, recorded at 6 h（T1） ,12 h（T2） ,24 h（T3） ,48 h（T4） after operation. And the pa-tients who had vomitted were counted at duration of 0 -6 h,6 -12 h, 12 -24 h,24-48 h. Results Compared with group Ⅰ,VSS at T1, T2 and T3 in group Ⅱ was significantly lower, while there was no dife- rence at T4. Compared with group I and group Ⅱ , VSS at T1, T2, T3 and T4 in group m was significant-ly lower. There were several vomining cases in three groups, and the number of vomitting cases in group m was the least in three groups. Conclusions The combination of penehyclidine hydroehloride and tro-pisetron can greatly reduce the occurrence of PONV, compared with tropisetron alone.