戊乙奎醚复合托烷司琼预防腹腔镜胆囊切除术后恶心呕吐的效果观察

Penehyelidine combined with tropisetron in prevention of nausea and vomiting after laparoscopic cholecystectomy

目的：探讨戊乙奎醚复合托烷司琼预防全身麻醉下行腹腔镜胆囊切除术后恶心呕吐的效果.方法：将60例在全身麻醉下行腹腔镜胆囊切除术的患者随机均分为3组,A组为戊乙奎醚联合托烷司琼组,B组为托烷司琼组,C组为0.9％氯化钠注射液对照组.观察术后24 h患者恶心呕吐情况.结果：C组在T1～T4恶心评分均明显高于A组和B组（P＜0.01）;T1、T2时A组视觉模拟评分均明显低于B组（P＜0.01）,T3、T4时2组视觉模拟评分差异无统计学意义（P＞0.05）.A组和B组在苏醒后0～6h、0～12 h和0～24 h内呕吐的发生率均明显低于C组（P＜0.01）;A组和B组呕吐的发生率差异均无统计学意义（P＞0.05）.结论：戊乙奎醚复合托烷司琼用于全麻腹腔镜胆囊切除术围手术期,可明显降低术后恶心呕吐的发生率,特别是在术后早期,其效果优于单独应用托烷司琼,值得临床推广应用.

Objective： To explore the prophylactic effect of penehyelidine combined with tropisetron in prevention of nausea and vomiting after laparoscopic cholecystectomy. Methods： Sixty patients having received laparoscopic cholecystectomy were randomly divided into three groups ： tropisetron combined with dexamethasone group （ group A）, tropisetron group （ group B ） and physiological saline group（ group C） ,with 20 cases in each. The incidence of postoperative nausea and vomiting was observed within 24 hours after the operation. Results： The visual analogus scales （VAS） score of nausea at T1 - T4 in group C was significantly higher than that in group A and group B（P 〈 0.01 ） ;the VAS score at T1 and T2 in group A was significantly lower than that in group B （P 〈 0.01 ） ;and there was no significant difference between the two groups in the VAS score at T3 and T4 （ P 〉 0. 05 ）. The incidence of vomiting after awakening from 0 to 6,0 to 12 and 0 to 24 hours in group A and group B was significantly lower than that in group C（P 〈0.01 ） ;and the incidences of vomiting in group A and B had no statistically significant difference （ P 〉 0.05 ）. Conclusions ： The application of penehydidine combined with tropisetron can obviously reduce the incidence of nausea and vomiting after laparoscopic cholecystectomy, and is more effective than using tropisetron alone. It is worth popularizing in clinical application.