术中液体治疗对甲状腺手术患者术后恶心呕吐的影响

Effect of intraoperative fluid therapy on postoperative nausea and vomiting in patients undergoing thyroid surgery

目的探讨术中液体治疗对甲状腺手术患者术后恶心呕吐(PONV)的影响。方法选取100例在全身麻醉下行甲状腺手术的患者,根据性别和液体治疗量分为男性10 mL/kg组、男性30 mL/kg组、女性10 mL/kg组和女性30 mL/kg组,每组25例,分别在术中予复方乳酸钠注射液10或30 mL/kg行液体治疗,比较4组苏醒期和术后24 h内的PONV发生率。结果男性10 mL/kg组苏醒期和术后24 h内的PONV发生率分别为4%和32%,男性30 mL/kg组均为0,女性10 mL/kg组分别为12%和72%,女性30 mL/kg组分别为8%和64%,男性30 mL/kg组苏醒期和术后24 h内的PONV发生率均显著低于其他3组同时间(P值均<0.05)。结论术中一定容量液体治疗可有效降低男性甲状腺手术患者PONV发生率。

Objective To investigate the effect of intraoperative fluid therapy on postoperative nausea and vomiting(PONV) in patients undergoing thyroid surgery. Methods A total of 100 patients undergoing thyroid surgery under general anesthesia were divided into male 10 mL/kg group, male 30 mL/kg group, female 10 mL/kg group and female 30 mL/kg group according to gender and fluid treatment. There were 25 patients in each group. Sodium lactate injection(10 or 30 mL/kg) was given intraoperatively in corresponding groups. The incidence of PONV was compared between the four groups in the recovery period and within 24 hours after surgery. Results The incidence rates of PONV in male 10 mL/kg group were 4% and 32% in the recovery period and within 24 hours after surgery, respectively. But no PONV occurred in the two periods in male 30 mL/kg group. The incidence rates of PONV in female 10 mL/kg group were 12% and 72% in the recovery period and within 24 hours after surgery, respectively, and 8% and 64% in female 30 mL/kg group. The incidence rates of PONV in male 30 mL/kg group in the recovery period and within 24 hours after surgery were significantly lower than those in the other 3 groups at the same time points(all P<0.05). Conclusion Intraoperative fluid therapy can effectively reduce the incidence of PONV in male patients with thyroid surgery.