氢化泼尼松和地塞米松对女性甲状腺手术后恶心呕吐的影响

Effects of hydrogenated prednisone and dexamethasone on post operative nausea and vomiting after thyroid surgery in women

目的比较氢化泼尼松和地塞米松对女性甲状腺手术后恶心呕吐(PONV)的影响。方法收集该院2020年6月至2021年6月择期在全身麻醉下行甲状腺手术的女性患者401例,根据麻醉前糖皮质激素用药不同分为3组,即氢化泼尼松组(H组,n=136)、地塞米松组(D组,n=144)、空白对照组(C组,n=121);比较患者术后6 h和24 h PONV发生率、静息痛及运动痛VAS评分、镇痛泵按压次数、头晕、腹胀、肛门排气及满意程度。结果术后6 h PONV发生率H组与D组均明显低于C组(P<0.01),H组低于D组(P<0.017)。术后24 h PONV发生率H组与D组均明显低于C组(P<0.01),D组低于H组(P<0.017)。与C组相比,术后24 h H组和D组患者满意度更高(P<0.05)。结论氢化泼尼松和地塞米松均可降低甲状腺手术后PONV的发生率,氢化泼尼松在术后6 h的作用更好,地塞米松在术后24 h更有优势。

Objective To compare the effects of hydrogenated prednisone and dexamethasone on post operative nausea and vomiting(PONV)after thyroid surgery in women.Methods From June 2020 to June 2021,a total of 401 female patients who underwent thyroid surgery under general anesthesia were retrospectively collected.They were divided into three groups according to the different glucocorticoid medications given before anesthesia,the hydrogenatedprednisone group(group H,n=136),the dexamethasone group(group D,n=144),and the control group(group C,n=121).The incidence of nausea and vomiting,the visual analogue scale(VAS)scores of resting and exercise pain,the times of pressing analgesia pump,dizziness,abdominal distension,anal exhaust and satisfaction were compared at 6 and 24 hours after surgery.Results The incidence of nausea and vomiting in group H and group D was significantly lower than that in group C at six hours after surgery(P<0.01),and there was a statistical difference between group H and group D(P<0.017).The incidence of nausea and vomiting in group H and group D was significantly lower than that in group C at 24 hours after surgery(P<0.01),and there was a statistical difference between group D and group H(P<0.017).Compared with group C,both group H and group D were able to improve patient satisfaction at 24 hours aftersurgery(P<0.05).Conclusion Hydrogenated prednisone and dexamethasone can reduce the incidence of PONV after thyroid surgery.The effect of prednisone is better at 6 hours after surgery,while dexamethasone is more advantageous at 24 hours after surgery.