长托宁联合昂丹司琼在预防全麻下妇科腹腔镜手术腹腔镜手术术后恶心呕吐的临床观察.docVIP

精品论文 参考文献 长托宁联合昂丹司琼在预防全麻下妇科腹腔镜手术腹腔镜手术术后恶心呕吐的临床观察 陈秋宇 唐祖恩 　　（达州市中心医院麻醉科 四川达州 635000） 　　【摘要】目的 探讨长托宁联合昂丹司琼在预防全麻下妇科腹腔镜手术术后恶心呕吐（PONV）的临床效果。方法 选取90例ASAⅠ～Ⅱ级,择期进行妇科腹腔镜手术的患者，随机分成A、B、C三组。A组为对照组、B组为昂丹司琼组、C组为长托宁联合昂丹司琼组,观察术后24h内患者恶心呕吐的发生几率及程度。结果 C组及B组术后24h内PONV的发生率和程度较A组明显减轻,Plt;0.05，差别有统计学意义；C组较B组术后24h内PONV的发生率和程度更低,Plt;0.05，差别有统计学意义。结论 长托宁联合昂丹司琼预防PONV有协同作用,可降低PONV的发生率及严重程度。 　　【关键词】长托宁 昂丹司琼 妇科腹腔镜手术 恶心呕吐 　　【中图分类号???R969 【文献标识码】A 【文章编号】2095-1752（2014）09-0063-02 　　 　　The clinical observation of penehyclidine hydrochloride combined with ondansetron in the prevention of PONV after gynecological laparoscopic surgery 　　【Abstract】Subject：This study aimed to investigate the clinical effect of the combination of penehyclidine hydrochloride and ondansetron on prevention of postoperative nausea and vomiting （PONV）after gynecological laparoscopic surgery under general anesthesia.Methods：90 ASA I—II patients undergoing elective laparoscopic operations were divided into three groups， and normal saline(group A)，ondansetron(group B) or penehyclidine hydrochloride combined with ondansetron (group C) were given randomly．The incidence and severity of PONV were recorded 24 hours after surgery。Results：The incidences and severity of PONV in group A were higher than group A and group B significantly (P lt; 0.05). And there were significant differences in the incidence and severity of PONV in group C and group B (Plt;0.05).Conclusion: The synergistic effect of penehyclidine hydrochloride combined with ondansetron was effective in reducing the incidence and severity of PONV. 　　【Key words】penehyclidine hydrochloride ondansetron gynecological laparoscopic surgery postoperative nausea and vomiting PONV 　　腹腔镜手术有创伤小、对腹腔脏器干扰少、术后恢复快以及术后疼痛较传统开腹手术程度轻等优点，在妇科手术中所占比例越来越高。但由于麻醉药物的残留，及气腹CO2气体的刺激和残留等因素，妇科腹腔镜手术术后恶心呕吐的发生率较常规的妇科开腹手术明显增高。术后恶心呕吐不仅给患者带来强烈的不适感,甚至会引起某些严重的并发症,如脱水、电解质紊乱、误吸、伤口裂开、颅内压升高等，这些都影响了术后的恢复和治疗。通过分析我院在全麻下行妇科腹腔镜手术中，使用长托宁联合昂丹司琼的病