加速康复外科中多拉司琼预防髋关节置换患者术后恶心呕吐的效果

Effect of Dolasetron in enhanced recovery after surgery in preventing postoperative nausea and vomiting in patients with hip replacement

目的探讨加速康复外科(ERAS)中多拉司琼预防髋关节置换患者术后恶心呕吐的效果。方法选取2018年1~12月汕头市第二人民医院收治的需行人工全髋关节置换手术治疗的60例患者作为研究对象,采用随机数字表法将其分为研究组(n=30)和对照组(n=30)。两组患者均常规行单侧人工全髋关节置换手术治疗,围术期通过ERAS进行干预,且研究组切皮前半小时行甲磺酸多拉司琼12.5 mg静脉滴注以预防术后恶心呕吐。比较两组患者术后恶心呕吐发生率、并发症总发生率,采用视觉模拟评分法(VAS)评价两组术前、术后的疼痛症状,术后3个月采用Harris髋关节功能评分评价两组的髋关节功能恢复状况。结果研究组患者术后的恶心呕吐发生率、并发症总发生率以及术后1和3个月的VAS评分均低于对照组,术后3个月的Harris髋关节功能评分高于对照组,差异有统计学意义(P<0.05);两组患者术后1和3个月的VAS评分均低于同组术前,差异有统计学意义(P<0.05)。结论多拉司琼在ERAS干预中应用效果良好,可有效预防髋关节置换患者术后恶心呕吐和促进关节功能恢复,值得推广应用。

Objective To investigate the effect of Dolasetron in enhanced recovery after surgery(ERAS)in preventing postoperative nausea and vomiting in patients with hip replacement.Methods From January to December 2018,60 patients in the Second People′s Hospital of Shantou who needed artificial total hip replacement were selected as the research objects and they were divided into the study group(n=30)and the control group(n=30)by the random number table method.Both of the two groups were treated with unilateral artificial total hip replacement and had perioperative ERAS intervention,and the patients in the study group received intravenous drip of 12.5 mg Dolasetron Mesylate half an hour before skin incision to prevent postoperative nausea and vomiting.The postoperative nausea and vomiting rate and total incidence rate of complications between the two groups were compared.The visual analogue scale(VAS)was used to evaluate the pain symptoms before and after operation of the two groups,and the Harris hip joint function score was used to evaluate the recovery of hip joint function in the two groups at 3 months after the operation.Results The nausea and vomiting rate,total incidence rate of complications,and the VAS scores at 1 and 3 months after operation in the study group were lower than those in the control group,and the Harris hip joint function score at 3 months after operation in the study group was higher that in the control group,with statistically significant differences(P<0.05).The VAS scores of the two groups at 1 and 3 months after operation were lower than those before operation in the same group,with statistically significant differences(P<0.05).Conclusion Dolasetron has a good effect in the intervention of ERAS,which can effectively prevent nausea and vomiting and promote the recovery of joint function in patients with hip replacement,and is worthy of promotion and application.