格拉司琼联合地塞米松预防妇科腹腔镜术后恶心呕吐的疗效观察.docVIP

格拉司琼联合地塞米松预防妇科腹腔镜术后恶心呕吐的疗效观察 【摘要】目的：评价格拉司琼联合地塞米松预防妇科腹腔镜术后恶心呕吐的临床疗效。方法：选择90例ASAⅠ～Ⅱ级行妇科腹腔镜手术的病人，随机将病人分为三组，在手术结束时分别静注格拉司琼3mg和地塞米松10mg(GD组，n=30)、格拉司琼3mg(G组，n=30)、生理盐水(对照组，NS组，n=30)。结果：在术后8小时内和9～24小时内恶心呕吐发生率GD组(16.7%、10.0%)和G组(20.0%、33.3%)明显低于NS组(63.3%、60.0%)(P＜0.05)，GD组在术后8小时内恶心呕吐发生率与G组比较无显著性差异(P＞0.05)，但在术后9～24小时内恶心呕吐发生率明显低于G组(10.0% vs 33.3%)(P＜0.05)。结论：格拉司琼联合地塞米松可显著减少妇科腹腔镜术后恶心呕吐发生率，而且其作用维持时间要长于单纯应用格拉司琼。 【关键词】格拉司琼；地塞米松；腹腔镜；恶心；呕吐 Clinical observation on granisetron combined dexamethasone in preventing postoperative nausea and vomiting for gynecologic laparoscopic surgery 【Abstract】Objective：To evaluate the prophylactic effect of granisetron combined with dexamethasone on postoperative nausea and vomiting(PONV) for gynecologic laparoscopic surgery. Methods：90 patients of ASAⅠ～Ⅱ undergone laparoscopic gynecologic operation were randomly divided into three groups，at the end of the operation which received respectively an intravenous bolus of granisetron 3mg and dexamethasone 10mg(group GD，n＝30)，granisetron 3mg(group G，n＝30)，0.9% NS 3ml(group placebo，group NS，n＝30).Results：The incidences of PONV in group GD (16.7%、10.0%) and group G (20.0%、33.3%) were significantly lower than those in group NS (63.3%、60.0%) (P＜0.05) in postoperative 8 hours and 9～24 hours. The incidence of PONV in group GD was similar to that in group G in postoperative 8 hours (P＞0.05)，but significantly lower than that in group G in postoperative 9～24 hours (10.0% vs 33.3%) (P＜0.05). Conclusion：Granisetron combined dexamethasone can significantly prevent PONV of gynecologic laparoscopic surgery，and the declination of effect was longer than that of granisetron only. 【Key words】Granisetron；Dexamethasone；Laparoscopic；Nausea；Vomiting ―――――――――――――――――――――――――――――――――――――――― 万震威 冯丹凤 彭为平 黄燕虹 黄文庆 512026 广东省粤北人民医院麻醉科万震威) 万震威，男，1973-02，本科，麻醉科主治医师，主攻心血管麻醉专业 妇科腹腔镜手术由于创伤小，恢复快等优点，已在临床上广泛开展，但其术后恶心呕吐(postoperative nausea and vomiting，PONV)的发生率较高，增加了病人的痛苦，影响了病人的康复。我们将格拉司琼联合地塞米松应用于妇科腹腔镜手术，观察其对PONV的预防作用。 1