参附注射液防治手术后恶心呕吐的临床应用 _临床医学论文.docVIP

参附注射液防治手术后恶心呕吐的临床应用 _临床医学论文 参附注射液防治手术后恶心呕吐的临床应用 _临床医学论文 　　【摘要】目的观察参附注射液对手术后恶心呕吐（PONV）的预防效果，探讨中药预防与治疗术后恶心呕吐的可行性。方法将60例经腹盆腔妇科手术患者，随机分为3组，每组20例（n=20）。参附组（S组）于手术开始前和手术结束前分别给予参附注射液20ml。恩丹西酮组（E组）于手术结束前给予恩丹西酮8mg。对照组（P组）手术结束前不另外给予止吐药物。3组病人均行经硬膜外术后镇痛，并于手术结束前经硬外管给予术后镇痛负荷剂量，分别在术后8h、24h、48h对病人作术后追踪观察并记录痛觉评分（采用视觉模拟评分法VAS）、恶心呕吐情况、使用止吐药的次数、腹部情况以及肛门排气时间等。结果在恶心程度方面，E组与S组显著优于P组（P＜0.01），而S组患者腹部感觉舒适程度又比E组好（0.05）。P组术后呕吐发生率较E组和S组高（P＜0.05），S组患者肛门排气时间较P组和E组短（P＜0.05）。结论参附注射液用于预防PONV有较好的效果，有利于促进术后胃肠功能恢复。 　　【关键词】手术后恶心呕吐；参附注射液；镇痛 　　ClinicalapplicationonthepreventiveandtherapeuticeffectsofShenfuInjectiononpostoperativenauseaandvomiting 　　 【Abstract】ObjectiveToobservethepreventiveandtherapeuticeffectsofShenfuInjectiononpostoperativenauseaandvomitingandexploreamethodoftraditionalChinesemedicinetopreventandtreatpostoperativenauseaandvomiting（PONV）.MethodsSixtypatientsundergoingelectivegynecologicalsurgeryunderspinalcombinedepiduralanaesthesiawererandomlydividedintothreegroups（n=20）.PatientsinGroupEweregivenendanstron8mgattheendofthesurgery，GroupSpatientsweregivenShenfuInjection20mlintravenouslybeforeoperationand30minutesbeforetheendofoperationrespectively，patientsinGroupPdidnotreceiveantiemeticmedication.Allpatientsreceivedpostoperativeepiduralanalgesia，theanalgesiamedicationincludeddroperidol1.5mgintheloadingdoseandmorphine8mgwith0.125%bupivacaine100mlinasyringewhichhas2ml/hinjectingrateintraepidurally.Thevisualanalgesiascoreandthefrequencyofnauseaandvomitingandantiemeticmedicationwererecordedat8hours、24hoursand48hoursafteroperation.ResultsThedegreeofnauseaofthepatientsinGroupEandGroupSweremoremarkedlyremittedthanthoseinGroupP（P＜0.01），patients’satisfactioninabdomeninGroupSwasbetterthanthatinGroupE（P＜0.05），theincidencesofvomitinginGroupSandGroupEwerelessthanthoseinGroupP（P＜0.05）.ConclusionProphylacticShenfuInjectioniseffectivetopreventPONVandimprovethegastrointestinalfunctionafteroperation. 　　【Keywords】postoperativenauseaandvomiting;ShenfuInjection;analgesia 　　手术后恶心呕吐（postoperativenauseaandvomiti