格拉司琼对后巩膜加固术术后剧烈呕吐患者的治疗作用

Effect of granisetron in treatment of postoperative severe vomiting after posterior scleral reinforcement

目的探讨格拉司琼对后巩膜加固术术后剧烈呕吐患者的治疗作用。方法选择2012年1月~2014年12月在温州医科大学附属眼视光医院行后巩膜加固术的患者84例,通过随机数表法分为观察组（n=42）和对照组（n=42）。对照组在手术结束时给予昂丹司琼,观察组在手术结束时给予格拉司琼。比较2组患者术后镇静、镇痛、恶心呕吐等情况。结果 2组患者在麻醉时间、手术时间、瑞芬太尼用量上无显著差异;观察组在术后30 min、术后1 h、术后2 h,Ramsay评分分别为（2.49±0.31）、（2.23±0.34）和（2.10±0.28）分,对照组在术后30 min、术后1 h、术后2 h,Ramsay评分分别为（3.02±0.42）、2.84±0.37）、（2.45±0.34）分,观察组Ramsay评分均比对照组低。2组患者术后30 min、术后1 h、术后2 h镇痛情况无显著差异;观察组术后恶心、呕吐总发生率分别为9.52%（4/32）、11.90%（5/42）,对照组术后恶心、呕吐总发生率分别为30.95%（13/42）、30.95%（13/42）,均低于对照组（P〈0.05）。结论在后巩膜加固术后使用格拉司琼,可有效减少术后剧烈呕吐的发生率,值得应用推广。

Objective To study curative efficacy of granisetron in treatment of postoperative severe vomiting after posterior scleral reinforcement.Methods 84 patients of posterior scleral reinforcement who received therapy from January 2012 to December 2014 in our hospital were selected as research objects. According to random number table,those patients were divided into the control group（ n = 100） and the observation group（ n = 100）,the control group were treated with ondansetron hydrochloride at the end of surgery,while the observation group were treated with granisetron at the end of surgery. Then postoperative sedation,analgesia,nausea,vomiting and so on. were compared. Results There were no significant differences in anesthesia time,operation time and remifentanil dosage between the two groups. The Ramsay scores of the observation group were（ 2. 49 ± 0. 31）,（ 2. 23 ± 0. 34） and（ 2. 10 ± 0. 28） points at 30 min,1h and 2h after operation,respectively. In the control group,Ramsay scores were（ 3. 02 ± 0. 42）,（ 2. 84 ± 0. 37）,（ 2. 45 ± 0. 34） at 30 min,1h and 2h after operation,lower than the control group. The incidence of nausea and vomiting in the observation group were 9. 52%（ 4 /32）,11. 90%（ 5 /42） respectively,and there was no significant difference between the two groups in the postoperative analgesia The total incidence of postoperative nausea and vomiting was 30. 95%（ 13 /42） and 30. 95%（ 13 /42） respectively,which were lower than the control group（ P〈0. 05）. Conclusion Granisetron is well for postoperative posterior scleral reinforcement,which can reduce the incidence of postoperative severe vomiting,it＇s worthy of application and promotion.